ABSTRACT
Purpose To assess the outcomes and variations in practice on the use of percutaneous cholecystostomy (PC) in patients with acute calculous cholecystitis (ACC). Material and Methods Data on consecutive patients who underwent PC for ACC between 1st January 2019 and 31st December 2020 were collected retrospectively from 36 hospitals within the United Kingdom as part of a national multi-centre audit project conducted by the UK National Interventional Radiology Trainee Research (UNITE) Network. Results 1186 patients [636 (53.6%) males, median age (range) 75 (24-102) years] who underwent PC (66.3% definitive treatment, 31.3% bridge to surgery) were included. A greater proportion of patients presented with complicated ACC during the COVID-19 pandemic compared with before (49.9% vs. 40.9%, p=0.007) resulting in more PCs being performed (61.3 per month vs. 37.9 per month, p<0.001). More PCs were performed in tertiary centres (9 vs. 3 per 100 beds, p<0.001) with a greater proportion as a bridge to surgery (50.5% vs. 22.8%, p<0.001) compared with district general hospitals. Cholangiograms via the PC drain were performed in 538 (45.9%) patients prior to removal. Conclusion PCs were predominantly performed as a definitive management in patients with ACC who were unfit for surgery. During the COVID-19 pandemic, a greater proportion of patients presented with complicated ACC resulting in an increased use of PCs. There is a wide variation in practice regarding the use of PCs, duration of tubes left in-situ and investigations performed prior to removal.
ABSTRACT
Purpose: The cyclic nature of active and recovery phases of the COVID-19 pandemic, has demanded fast adaptations and preparation for health care workers world-wide. We aimed to assess how interventional radiologists are handling the pandemic during active and recovery phases with regard to work and team structures, as well as mental health and how the pandemic could have increased the awareness of minimally-invasive therapies as alternatives to postponements of non-urgent procedures. Material and methods: 7125 CIRSE members were invited to participate. For this interim report, responses were collected between 23 November 2021 and 17 December 2021. Results: 114 responses were obtained for this preliminary report, of which 102 were complete. 94% (n=99) of respondents were interventional radiology specialists. Most respondents reported having established a routine to handle different waves of the pandemic (89.5%;n=102). Compared to active phases, fewer respondents indicated at least one pandemic-associated measure in their department during recovery phases (46%-71% vs 13%). 56% reported an increase in ambulatory care patients either during active and/or recovery phases. 54% reported more referrals during active and/or recovery phases. 25% reported increased hours at the hospital during recovery phases, 52% indicated increased sick leave, care leave, quarantine, and burn-out of team members and only 39% reported to get enough time to rest during recovery phases. Conclusion: While the COVID-19 pandemic is continuing to burden IR departments and the mental health of IRs, more than half of respondents reported an increase in referrals for minimally-invasive therapies and ambulatory care.
ABSTRACT
BACKGROUND: The COVID-19 pandemic had an unprecedented impact on clinical practice and healthcare professionals. We aimed to assess how interventional radiology services (IR services) were impacted by the pandemic and describe adaptations to services and working patterns across the first two waves. METHODS: An anonymous six-part survey created using an online service was distributed as a single-use web link to 7125 members of the Cardiovascular and Interventional Radiological Society of Europe via email. Out of 450 respondents, 327 who completed the survey at least partially including 278 who completed the full survey were included into the analysis. RESULTS: Interventional radiologists (IRs) reported that the overall workload decreased a lot (18%) or mildly (36%) or remained stable (29%), and research activities were often delayed (30% in most/all projects, 33% in some projects). Extreme concerns about the health of families, patients and general public were reported by 43%, 34% and 40%, respectively, and 29% reported having experienced significant stress (25% quite a bit; 23% somewhat). Compared to the first wave, significant differences were seen regarding changes to working patterns, effect on emergency work, outpatient and day-case services in the second wave. A total of 59% of respondents felt that their organisation was better prepared for a third wave. A total of 19% and 39% reported that the changes implemented would be continued or potentially continued on a long-term basis. CONCLUSION: While the COVID-19 pandemic has negatively affected IR services in terms of workload, research activity and emotional burden, IRs seem to have improved the own perception of adaptation and preparation for further waves of the pandemic.
Subject(s)
COVID-19 , Humans , Pandemics/prevention & control , Radiologists , Radiology, Interventional , Surveys and QuestionnairesABSTRACT
AIM: To review data on the impact of the COVID-19 pandemic on interventional radiology (IR) services. MATERIALS AND METHODS: A systematic review of the available studies was performed according to the PRISMA guidelines. RESULTS: A total of 14 studies met the inclusion criteria. IR caseload reduced between 16.8-80%, with elective activity affected more than emergency work. Trainees also experienced a 11-51.9% reduction in case volumes and many were redeployed to critical care. IR departments re-organised operations and personnel, and many continued to offer 24/7 services and support critical care areas through redeployment of staff. The majority of studies report no significant issues with the availability of personal protective equipment and that local or national governing body or radiology society guidelines were followed. CONCLUSION: The COVID-19 pandemic reduced case volumes and training opportunities. IR departments showed flexibility in service delivery. The lessons learned offer novel insights into how services and training can be reorganised to ensure that IR continues to thrive.