Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 18 de 18
Filter
1.
Dermatol Surg ; 47(7): 931-933, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1517923

ABSTRACT

BACKGROUND: The reallocation of health care resources to focus on the acute care needs of COVID-19 patients leads to a delay and deferral of outpatient surgical procedures such as Mohs surgery. OBJECTIVE: Planning for the resumption of regular outpatient surgical care and preparing for future surges in COVID-19 cases requires identifying surrogate markers of health care demand. MATERIALS AND METHODS: United States national and state-based Google search data for "Mohs surgery" and other common elective surgical and cosmetic procedures were evaluated. These were compared with national and state-wide COVID-19 case number and death data from the Johns Hopkins University. Pearson correlation coefficients were generated to assess the association between COVID-19 cases and deaths with Google search trends. RESULTS: Search volume for "Mohs surgery" and other elective surgical and cosmetic procedures significantly decreased as the number of new deaths from COVID-19 increased. Statistically significant inverse correlation was noted between "Mohs surgery" search volume and new COVID-19 deaths on a national and state-based level. CONCLUSION: Search metric analysis may be used as part of a big data model to help predict health care demand during the reopening phase of the COVID-19 pandemic.


Subject(s)
Ambulatory Surgical Procedures/statistics & numerical data , Attitude to Health , COVID-19/epidemiology , Cosmetic Techniques/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Mohs Surgery/statistics & numerical data , Humans , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , United States/epidemiology
2.
Am Surg ; 88(3): 489-497, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1506800

ABSTRACT

OBJECTIVES: COVID-19 has caused significant surgical delays as institutions minimize patient exposure to hospital settings and utilization of health care resources. We aimed to assess changes in surgical case mix and outcomes due to restructuring during the pandemic. METHODS: Patients undergoing surgery at a single tertiary care institution in the Deep South were identified using institutional ACS-NSQIP data. Primary outcome was case mix. Secondary outcomes were post-operative complications. Chi-square, ANOVA, logistic regression, and linear regression were used to compare the control (pre-COVID, Mar 2018-Mar 2020) and case (during COVID, Mar 2020-Mar 2021) groups. RESULTS: Overall, there were 6912 patients (control: 4,800 and case: 2112). Patients were 70% white, 29% black, 60% female, and 39% privately insured. Mean BMI was 30.2 (SD = 7.7) with mean age of 58.3 years (SD = 14.8). Most surgeries were with general surgery (48%), inpatient (68%), and elective (83%). On multivariable logistic regression, patients undergoing surgery during the pandemic were more likely to be male (OR: 1.14) and in SIRS (OR: 2.07) or sepsis (OR: 2.28) at the time of surgery. Patients were less likely to have dyspnea with moderate exertion (OR: .75) and were less dependent on others (partially dependent OR: .49 and totally dependent OR: .15). Surgeries were more likely to be outpatient (OR: 1.15) and with neurosurgery (OR: 1.19). On bivariate analysis, there were no differences in post-operative outcomes. CONCLUSION: Surgeries during the COVID-19 pandemic were more often outpatient without differences in post-operative outcomes. Additional analysis is needed to determine the impact of duration of operative delay on surgical outcomes with restructuring focusing more on outpatient surgeries.


Subject(s)
COVID-19/epidemiology , Diagnosis-Related Groups , Pandemics , Surgical Procedures, Operative/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Alabama , Ambulatory Surgical Procedures/statistics & numerical data , Case-Control Studies , Elective Surgical Procedures/statistics & numerical data , Female , General Surgery/statistics & numerical data , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Regression Analysis , Tertiary Care Centers , Treatment Outcome , Young Adult
3.
J Plast Reconstr Aesthet Surg ; 74(11): 3178-3185, 2021 11.
Article in English | MEDLINE | ID: covidwho-1491753

ABSTRACT

The novel coronavirus outbreak (COVID-19) in 2019 resulted in the suspension of all elective hospital procedures during the height of the pandemic in the UK. The Clinic in London is one of the first day-case hospitals to resume cosmetic surgery in a post-COVID-19 clinical environment, whilst also employing the use of virtual consultations. Details of the protocol implemented by the Clinic to allow the safe resumption of cosmetic surgery are stated in this paper. The volume of procedures at the Clinic saw a significant increase post-lockdown; reasons as to why this occurred are also explored in this paper. The disruption of cosmetic practice during lockdown can be said to have resulted in a backlog of procedures once lockdown restrictions began to ease. Whilst this may be true, we believe that there are other confounding factors regarding what may have influenced the rise in cosmetic surgery during the pandemic, including the privacy of working from home and the increased exposure to video conferencing software.


Subject(s)
Ambulatory Surgical Procedures , COVID-19 , Pandemics , Reconstructive Surgical Procedures , Ambulatory Surgical Procedures/statistics & numerical data , Cohort Studies , Hospitals , Humans , Infection Control , London/epidemiology , Patient Selection , Reconstructive Surgical Procedures/statistics & numerical data , Remote Consultation , Retrospective Studies
4.
Ann R Coll Surg Engl ; 104(3): 165-173, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1331976

ABSTRACT

INTRODUCTION: We have seen unparalleled changes in our healthcare systems globally as a result of the COVID-19 pandemic. As we strive to regenerate our full capacity elective services in order to contest the increasing demand for lower limb arthroplasty, this pandemic has allowed us a rare opportunity to revise and develop novel elective arthroplasty pathways intended to improve patient care and advance healthcare efficiency. We present an extensive evidence-based review of the approaches used to achieve day-case unicompartmental arthroplasty (UKA) as well as the development of a day-case UKA care pathway in a UK NHS institution based on the evidence provided in the literature. METHODS: An extensive search of the literature was performed for articles that reported on readmission or complication rates ≥30 days postoperatively following day-case UKA. FINDINGS: Fifteen manuscripts reporting the results of day-case UKA, defined as discharged on the same calendar day of surgery, were included in our review. Mean reported complication rates for day-case and inpatient UKA within the follow-up periods were 4.05% and 6.52%, respectively. Mean readmission rates were 2.71% and 4.36% for day-case and inpatient UKA, respectively. The mean rate of successful same-day discharge was 92.45%. CONCLUSION: We introduce our institutional Elective Day Surgery Arthroplasty Pathway (EDSAP) founded upon the evidence presented in the literature. Stringent patient selection complimented by a well-defined day-case arthroplasty pathway is fundamental for successful commencement of day-case UKA in the NHS.


Subject(s)
Ambulatory Surgical Procedures , Arthroplasty, Replacement, Knee , Aged , Ambulatory Surgical Procedures/adverse effects , Ambulatory Surgical Procedures/methods , Ambulatory Surgical Procedures/statistics & numerical data , Arthroplasty, Replacement, Knee/adverse effects , Arthroplasty, Replacement, Knee/methods , Arthroplasty, Replacement, Knee/statistics & numerical data , COVID-19 , Humans , Middle Aged , Patient Discharge/statistics & numerical data , Patient Readmission/statistics & numerical data , Postoperative Complications/epidemiology
5.
Ann R Coll Surg Engl ; 103(7): 496-498, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1288680

ABSTRACT

As the COVID-19 pandemic progressed across the UK and Northern Ireland in March 2020, our otolaryngology department began to make preparations and changes in practice to accommodate for potentially large numbers of patients with COVID-19 related respiratory illness in the hospital. We retrospectively reviewed the number of non-elective admissions to our department between the months of January and May in 2019 and 2020. A significant reduction in admissions of up to 94% during the months of the pandemic was observed. Our practice shifted to manage patients with epistaxis and peritonsillar abscess on an outpatient basis, and while prospectively collecting data on this, we did not observe any significant adverse events. We view this as a positive learning point and change in our practice as a result of the COVID-19 pandemic.


Subject(s)
Ambulatory Surgical Procedures/trends , COVID-19/prevention & control , Otorhinolaryngologic Surgical Procedures/trends , Patient Admission/trends , Surgery Department, Hospital/trends , Ambulatory Surgical Procedures/standards , Ambulatory Surgical Procedures/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Epistaxis/surgery , Humans , Infection Control/standards , Northern Ireland/epidemiology , Otorhinolaryngologic Surgical Procedures/standards , Otorhinolaryngologic Surgical Procedures/statistics & numerical data , Pandemics/prevention & control , Patient Admission/standards , Patient Admission/statistics & numerical data , Peritonsillar Abscess/surgery , Retrospective Studies , Surgery Department, Hospital/standards , Surgery Department, Hospital/statistics & numerical data
6.
Ann R Coll Surg Engl ; 103(7): 478-480, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1288679

ABSTRACT

BACKGROUND: There is limited evidence on perioperative outcomes of surgical patients during the COVID-19 pandemic to inform continued operating into the winter period. METHODS: We retrospectively analysed the rate of 30-day COVID-19 transmission and mortality of all surgical patients in the three hospitals in our trust in the East of England during the first lockdown in March 2020. All patients who underwent a swab were swabbed on or 24 hours prior to admission. RESULTS: There were 4,254 patients and an overall 30-day mortality of 0.99%. The excess surgical mortality in our region was 0.29%. There were 39 patients who were COVID-19 positive within 30 days of admission, 12 of whom died. All 12 were emergency admissions with a length of stay longer than 24 hours. There were three deaths among those who underwent day case surgery, one of whom was COVID-19 negative, and the other two were not swabbed but not suspected to have COVID-19. There were two COVID-19 positive elective cases and none in day case elective or emergency surgery. There were no COVID-19 positive deaths in elective or day case surgery. CONCLUSIONS: There was a low rate of COVID-19 transmission and mortality in elective and day case operations. Our data have allowed us to guide patients in the consent process and provided the evidence base to restart elective and day case operating with precautions and regular review. A number of regions will be similarly affected and should perform a review of their data for the winter period and beyond.


Subject(s)
Ambulatory Surgical Procedures/mortality , COVID-19/epidemiology , Elective Surgical Procedures/mortality , Emergency Treatment/mortality , Ambulatory Surgical Procedures/standards , Ambulatory Surgical Procedures/statistics & numerical data , COVID-19/complications , COVID-19/diagnosis , COVID-19/transmission , COVID-19 Testing/standards , COVID-19 Testing/statistics & numerical data , Elective Surgical Procedures/standards , Elective Surgical Procedures/statistics & numerical data , Emergency Service, Hospital/standards , Emergency Service, Hospital/statistics & numerical data , Emergency Treatment/standards , Emergency Treatment/statistics & numerical data , England/epidemiology , Female , Hospital Mortality , Humans , Incidence , Infection Control/standards , Infection Control/statistics & numerical data , Length of Stay/statistics & numerical data , Male , Pandemics/prevention & control , Pandemics/statistics & numerical data , Patient Admission/standards , Patient Admission/statistics & numerical data , Retrospective Studies , SARS-CoV-2/isolation & purification , State Medicine/standards , State Medicine/statistics & numerical data
7.
Ann R Coll Surg Engl ; 103(7): 487-492, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1288676

ABSTRACT

INTRODUCTION: In response to the COVID-19 pandemic, our emergency general surgery (EGS) service underwent significant restructuring, including establishing an enhanced ambulatory service and undertaking nonoperative management of selected pathologies. The aim of this study was to compare the activity of our EGS service before and after these changes. METHODS: Patients referred by the emergency department were identified prospectively over a 4-week period beginning from the date our EGS service was reconfigured (COVID) and compared with patients identified retrospectively from the same period the previous year (Pre-COVID), and followed up for 30 days. Data were extracted from handover documents and electronic care records. The primary outcomes were the rate of admission, ambulation and discharge. RESULTS: There were 281 and 283 patients during the Pre-COVID and COVID periods respectively. Admission rate decreased from 78.7% to 41.7%, while there were increased rates of ambulation from 7.1% to 17.3% and discharge from 6% to 22.6% (all p<0.001). For inpatients, mean duration of admission decreased (6.9 to 4.8 days), and there were fewer operative or endoscopic interventions (78 to 40). There were increased ambulatory investigations (11 to 39) and telephone reviews (0 to 39), while early computed tomography scan was increasingly used to facilitate discharge (5% vs 34.7%). There were no differences in 30-day readmission or mortality. CONCLUSIONS: Restructuring of our EGS service in response to COVID-19 facilitated an increased use of ambulatory services and imaging, achieving a decrease of 952 inpatient bed days in this critical period, while maintaining patient safety.


Subject(s)
COVID-19/prevention & control , Emergency Service, Hospital/organization & administration , Emergency Treatment/statistics & numerical data , General Surgery/organization & administration , Surgery Department, Hospital/organization & administration , Adult , Aged , Ambulatory Surgical Procedures/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Conservative Treatment/statistics & numerical data , Emergency Service, Hospital/standards , Emergency Service, Hospital/statistics & numerical data , Emergency Treatment/methods , Emergency Treatment/standards , Female , Follow-Up Studies , General Surgery/standards , General Surgery/statistics & numerical data , Hospital Mortality , Humans , Infection Control/organization & administration , Infection Control/standards , Male , Middle Aged , Pandemics/prevention & control , Patient Readmission/statistics & numerical data , Patient Safety/standards , Prospective Studies , Referral and Consultation/organization & administration , Referral and Consultation/standards , Referral and Consultation/statistics & numerical data , Retrospective Studies , SARS-CoV-2/isolation & purification , Surgery Department, Hospital/standards , Surgery Department, Hospital/statistics & numerical data
8.
J Gynecol Obstet Hum Reprod ; 50(9): 102166, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1240456

ABSTRACT

OBJECTIVE: This study examined the impact of lockdown for SARS-CoV-2 on breast cancer management via an online survey in a French multicentre setting. MATERIAL AND METHODS: This is a multicentre retrospective study, over the strict lockdown period from March 16th to May 11th, 2020 in metropolitan France. 20 centres were solicited, of which 12 responded to the survey. RESULTS: 50% of the centres increased their surgical activity, 33% decreased it and 17% did not change it during containment. Some centres had to cancel (17%) or postpone (33%) patient-requested interventions due to fear of SARS-CoV-2. Four and 6 centres (33% and 50%) respectively cancelled and postponed interventions for medical reasons. In the usual period, 83% of the centres perform their conservative surgeries on an outpatient basis, otherwise the length of hospital stay was 24 to 48 h. All the centres except one performed conservative surgery on an outpatient basis during the lockdown period, for which. 8% performed mastectomies on an outpatient basis during the usual period. During lockdown, 50% of the centres reduced their hospitalization duration (25% outpatient /25% early discharge on Day 1). CONCLUSION: This study explored possibilities for management during the first pandemic lockdown. The COVID-19 pandemic required a total reorganization of the healthcare system, including the care pathways for cancer patients.


Subject(s)
Breast Neoplasms/surgery , Breast Neoplasms/therapy , COVID-19/prevention & control , SARS-CoV-2 , Surgical Procedures, Operative/statistics & numerical data , Ambulatory Surgical Procedures/statistics & numerical data , Conservative Treatment/statistics & numerical data , Female , France , Humans , Length of Stay , Mammaplasty/statistics & numerical data , Mastectomy/statistics & numerical data , Patient Isolation/methods , Retrospective Studies , Surveys and Questionnaires
11.
J Perioper Pract ; 31(3): 62-70, 2021 03.
Article in English | MEDLINE | ID: covidwho-1067156

ABSTRACT

BACKGROUND: The UK practice of laparoscopic cholecystectomy has reduced during the COVID-19 pandemic due to cancellation of non-urgent operations. Isolated day-case units have been recommended as 'COVID-cold' operating sites to resume surgical procedures. This study aims to identify patients suitable for day case laparoscopic cholecystectomy (DCLC) at isolated units by investigating patient factors and unexpected admission. METHOD: Retrospective analysis of 327 patients undergoing DCLC between January and December 2018 at Ysbyty Gwynedd (District General Hospital; YG) and Llandudno General Hospital (isolated unit; LLGH), North Wales, UK. RESULTS: The results showed that 100% of DCLCs in LLGH were successful; 71.4% of elective DCLCs were successful at YG. Increasing age (p = 0.004), BMI (p = 0.01), ASA Score (p = 0.006), previous ERCP (p = 0.05), imaging suggesting cholecystitis (p = 0.003) and thick-walled gallbladder (p = 0.04) were significantly associated with failed DCLC on univariate analysis. Factors retaining significance (OR, 95% CI) after multiple regression include BMI (1.82, 1.05-3.16; p = 0.034), imaging suggesting cholecystitis (4.42, 1.72-11.38; p = 0.002) and previous ERCP (5.25, 1.53-18.00; p = 0.008). Postoperative complications are comparable in BMI <35kg/m2 and 35-39.9kg/m2. CONCLUSIONS: Current patient selection for isolated day unit is effective in ensuring safe discharge and could be further developed with greater consideration for patients with BMI 35-39.9kg/m2. As surgical services return, this helps identify patients suitable for laparoscopic cholecystectomy at isolated COVID-free day units.


Subject(s)
Ambulatory Surgical Procedures/statistics & numerical data , COVID-19/epidemiology , Cholecystectomy, Laparoscopic/statistics & numerical data , Adult , Cholecystitis/surgery , Elective Surgical Procedures/statistics & numerical data , Female , Gallbladder/surgery , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Retrospective Studies , Wales
12.
Ulus Travma Acil Cerrahi Derg ; 27(1): 34-42, 2021 01.
Article in English | MEDLINE | ID: covidwho-1041556

ABSTRACT

BACKGROUND: Acute cholecystitis (AC), a common complication of gallstones, is responsible for a significant part of emergency applications, and cholecystectomy is the only definitive treatment method for AC. Early cholecystectomy has many reported advantages. Operation-related morbidity and mortality have increased during the COVID-19 pandemic. In this study, our aim is to present our general clinical approach to patients who were diagnosed with AC during the pandemic and our percutaneous cholecystostomy experience during this period. METHODS: This study included 72 patients who were presented to our hospital's emergency room between March 11 and May 31, 2020, with AC. Patients were divided into three groups based on their treatment: outpatients (Group 1), inpatients (Group 2) and patients undergoing percutaneous cholecystostomy (Group 3). These three groups were compared by their demographic and clinical characteristics. RESULTS: There were 36 (50%) patients in Group 1, 25 (34.7%) patients in Group 2, and 11 (15.3%) patients in Group 3. The demographic characteristics of the patients were similar. The CRP and WBC levels of the patients in Group 3 were significantly higher compared to the other groups. Moreover, the wall of the gallbladder was thicker and the size of the gallbladder was larger in Group 3. Patients had percutaneous cholecystostomy at the median of 3.5 days and the length of hospital stay was longer compared to Group 2 (3.9 days versus 9.2 days, p=0.00). The rate of re-hospitalization after discharge was similar in Group 2 and Group 3, but none of the patients in Group 1 required hospitalization. None of 72 patients developed an emergency condition requiring surgery, and there was no death. CONCLUSION: Although many publications emphasize that laparoscopic cholecystectomy (LC) can be performed with low morbidity at the first admission in acute cholecystitis, it is a clinical condition that can be delayed in the COVID-19 pandemic and other similar emergencies. Thus, percutaneous cholecystostomy should be effectively employed, and its indications should be extended if necessary (e.g., younger patients, patients with lower CCI or ASA). This approach may enable us to protect both patients and healthcare professionals that perform the operation from the risk of COVID-19.


Subject(s)
Ambulatory Surgical Procedures/statistics & numerical data , COVID-19 , Cholecystectomy , Cholecystitis, Acute , Hospitalization/statistics & numerical data , Cholecystectomy/methods , Cholecystectomy/statistics & numerical data , Cholecystitis, Acute/epidemiology , Cholecystitis, Acute/surgery , Emergency Service, Hospital , Humans , Pandemics , SARS-CoV-2
13.
J Plast Reconstr Aesthet Surg ; 74(4): 890-930, 2021 04.
Article in English | MEDLINE | ID: covidwho-912070

ABSTRACT

The COVID-19 outbreak is a global problem affecting the world in many respects. In the medical field, its impact on surgical branches as well as clinical branches is inevitable. From the plastic surgery perspective, the COVID-19 outbreak affects the number and distribution of surgeries, patient admissions and educational activities. Although these impacts are predictable, it is beneficial to document these data that would contribute to the proper response to a similar crisis in the future. From this standpoint, the present study aims to analyze the effect of the COVID-19 pandemic on plastic surgery practice in some aspects. Epidemiologic data of the two-time frames, routine period, and pandemic period of plastic surgery were reviewed retrospectively. The ratios of the listed data were compared between the two periods; admissions to the outpatient clinic, surgeries, consultations, anesthesia type, hospitalizations, and demographic data. While the number of outpatient clinic patients was 3511 in the routine period, it was 490 in the pandemic period. Compared to the routine period, the number of surgical interventions was decreased from 793 to 129 during the pandemic period. In particular, a statistically significant increase was observed in the rate of hand trauma and maxillofacial trauma cases during the pandemic period compared with the routine period (p < 0.001, and p = 0.032, respectively). Therefore, high rates of hand trauma and maxillofacial trauma should be taken into consideration when making arrangements such as personnel distribution, use of medical resources, and regulation of hospital infrastructure in extraordinary situations like COVID-19 pandemics.


Subject(s)
Ambulatory Surgical Procedures/statistics & numerical data , COVID-19/epidemiology , Hospitalization/statistics & numerical data , Infection Control/organization & administration , Reconstructive Surgical Procedures/statistics & numerical data , Surgery, Plastic/organization & administration , COVID-19/prevention & control , COVID-19/transmission , Humans
14.
J Clin Anesth ; 67: 110024, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-707531

ABSTRACT

STUDY OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic impacts operating room (OR) management in regions with high prevalence (e.g., >1.0% of asymptomatic patients testing positive). Cases with aerosol producing procedures are isolated to a few ORs, initial phase I recovery of those patients is in the ORs, and multimodal environmental decontamination applied. We quantified the potential increase in productivity from also resequencing these cases among those 2 or 3 ORs. DESIGN: Computer simulation provided sample sizes requiring >100 years experimentally. Resequencing was limited to changes in the start times of surgeons' lists of cases. SETTING: Ambulatory surgery center or hospital outpatient department. MAIN RESULTS: With case resequencing applied before and on the day of surgery, there were 5.6% and 5.5% more cases per OR per day for the 2 ORs and 3 ORs, respectively, both standard errors (SE) < 0.1%. Resequencing cases among ORs to start cases earlier permitted increases in the hours into which cases could be scheduled from 10.5 to 11.0 h, while assuring >90% probability of each OR finishing within the prespecified 12-h shift. Thus, the additional cases were all scheduled before the day of surgery. The greater allocated time also resulted in less overutilized time, a mean of 4.2 min per OR per day for 2 ORs (SE 0.5) and 6.3 min per OR per day for 3 ORs (SE 0.4). The benefit could be achieved while limiting application of resequencing to days when the OR with the fewest estimated hours of cases has ≤8 h. CONCLUSIONS: Some ambulatory surgery ORs have unusually long OR times and/or room cleanup times (e.g., infection control efforts because of the pandemic). Resequencing cases before and on the day of surgery should be considered, because moving 1 or 2 cases occasionally has little to no cost with substantive benefit.


Subject(s)
Ambulatory Care Facilities/organization & administration , Ambulatory Care Facilities/statistics & numerical data , Ambulatory Surgical Procedures/statistics & numerical data , COVID-19 , Operating Rooms/organization & administration , Operating Rooms/statistics & numerical data , Pandemics , Personnel Staffing and Scheduling , Aerosols , Appointments and Schedules , COVID-19/prevention & control , Computer Simulation , Decontamination , Efficiency , Environmental Restoration and Remediation , Humans , Infection Control
15.
Updates Surg ; 72(4): 1255-1261, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-705286

ABSTRACT

Proctology is one of the surgical specialties that suffered the most during COVID-19 pandemic. Using data from a cross-sectional worldwide web survey, we aimed to snapshot the current status of proctologic practice in Italy with differences between three macro areas (North, Centre, South). Specialists affiliated to renowned scientific societies with an interest in coloproctology were invited to join a 27-item survey. Predictive power of respondents' and hospitals' demographics on the change of status of surgical activities was calculated. The study was registered at ClinicalTrials.gov (NCT04392245). Of 299 respondents from Italy, 94 (40%) practiced in the North, 60 (25%) in the Centrer and 82 (35%) in the South and Islands. The majority were men (79%), at consultant level (70%), with a mean age of 46.5 years, practicing in academic hospitals (39%), where a dedicated proctologist was readily available (68%). Southern respondents were more at risk of infection compared to those from the Center (OR, 3.30; 95%CI 1.46; 7.47, P = 0.004), as were males (OR, 2.64; 95%CI 1.09; 6.37, P = 0.031) and those who routinely tested patients prior to surgery (OR, 3.02; 95%CI 1.39; 6.53, P = 0.005). The likelihood of ongoing surgical practice was higher in the South (OR 1.36, 95%CI 0.75; 2.46, P = 0.304) and in centers that were not fully dedicated to COVID-19 care (OR 4.00, 95%CI 1.88; 8.50, P < 0.001). The results of this survey highlight important factors contributing to the deadlock of proctologic practice in Italy and may inform the development of future management strategies.


Subject(s)
COVID-19/epidemiology , Colorectal Surgery/statistics & numerical data , Health Care Surveys , Health Services Accessibility , Ambulatory Surgical Procedures/statistics & numerical data , COVID-19/prevention & control , COVID-19/transmission , Elective Surgical Procedures/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , Female , Hospital Administration , Humans , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Italy/epidemiology , Male , Middle Aged , Pandemics
SELECTION OF CITATIONS
SEARCH DETAIL