ABSTRACT
AIM: To analyze the epidemiological characteristics of patients hospitalized for ocular trauma during the novel coronavirus (COVID-19) epidemic. METHODS: A retrospective case analysis. Totally 876 cases (905 eyes) of ocular trauma were analyzed in this study, including 545 cases (565 eyes) from January to June 2019 were enrolled ascontrol group, and 331 cases (340 eyes) from January to June 2020 were enrolled in the research group. Information regarding age, sex, location of injury, cause of injury, place of residence, and type of injury were collected and analyzed. RESULTS: The number of hospitalisation for ocular trauma in the research group decreased by 39.3% compared with the control group. The age distribution of patients showed a double peak, at 0-10 years (20.55%, 21.45%) and 41-50 years (17.98%, 19.03%) in the control group and research group, respectively. There was no statistically significant difference in the age distribution between the two groups (P=0.907). Men were predominantly injured in both the control and the research groups, accounting for 80.37% and 83.69%, respectively (P=0.219). The proportion of home injuries in the research group (28.40%) was higher than the control group (11.38%) (P<0.001). The proportion of mechanical eye injuries in the research group (98.19%) was higher than the control group (95.60%) (P=0.041), and the proportion of open globe injuries (85.54%) was also higher than the control group (76.58%) (P=0.001). The proportion of patients with no light perception in the research group (18.86%) was higher than that of the control group (9.53%) (P<0.001). CONCLUSION: During the COVID-19 epidemic period, the total number of ocular trauma cases was significantly reduced. Mechanical eye injuries are still the main type for hospitalisation of patients with eye injuries. The awareness of eye injury prevention should be strengthened during the period of epidemic. Copyright 2022 by the IJO Press.
ABSTRACT
Background. In early months of COVID-19 pandemic, SGH recorded a year-on-year increase in antibiotic (ABx) use for community acquired acute respiratory infection (CA ARI) from Feb-Apr 2019 (48.7 defined daily doses (DDD)/100 bed-days) to 2020 (50.8 DDD/100 bed-days). To address concerns of misuse, the antibiotic stewardship unit (ASU) expanded prospective audit feedback (PAF) to CA ARI patients admitted to ARI wards, with low procalcitonin (PCT). PAF was conducted on day 2-3 of ABx, on weekdays. Doctors received feedback to stop/ modify when ABx was deemed inappropriate. Here, we describe the impact of ASU's adaptive approach to curb rising ABx use in patients admitted for ARI during COVID-19 pandemic. Methods. A Pre- & Post-intervention study was conducted. All patients started on ABx (ceftriaxone/co-amoxiclav/piptazo/carbapenems/levofloxacin) for CA ARI & PCT < 0.5μg/L were analysed. Those who died ≤48h of admission;admitted to intensive care;required ABx escalation;>1 infective sites;complex lung infection were excluded. Primary objective was to compare the proportion of ABx stopped ≤4 days (time to final infection diagnosis) Pre (22/3-18/4/20) & Post (21/4-13/7/20). Results. 184 (Pre) & 528 (Post) ABx courses were analysed. ASU audited 51 (Pre) & 380 (Post) courses with the rest discontinued/discharged before review. Patients were largely similar in both periods;a third had low likelihood of bacterial infection (C reactive protein < 30mg/L). In Post, 73 feedback was given to stop ABx (often because symptoms suggested viral/fluid overload) & 18 to switch to oral ABx. 82 (90%) feedback was accepted. No ABx was restarted ≤48h or deaths ≤30 days due to ARI. 1 patient had C. difficile diarrhoea a day after ABx cessation as per ASU feedback. Proportion of all ABx stopped ≤4 days was higher in Post than Pre [27/184 (15%) vs 152/528 (29%), p< 0.01]. Median duration of therapy of IV ABx was reduced (6.5 vs 3 days, p< 0.01), with corresponding shorter median length of stay (10.5 vs 6 days, p< 0.01). Conclusion. PAF directly and indirectly reduced ABx duration in patients treated for CA ARI as prescribers become more conscious about stopping ABx when investigations show low likelihood of bacterial infection. ASU must remain agile during pandemics to detect emerging problems and adapt processes to counter early.