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1.
Khirurgiia (Mosk) ; (12): 5-14, 2021.
Article in Russian | MEDLINE | ID: covidwho-1599976

ABSTRACT

OBJECTIVE: To study the impact of the SARS-CoV-2 pandemic on surgical care in the Russian Federation. MATERIAL AND METHODS: A retrospective cohort study of surgical care in state medical organizations of the Russian Federation in 2020 was conducted in comparison with 2019. The electronic database of the annual reports of the Chief surgeon of the Ministry of Health of the Russian Federation was used, which includes data from 3.232 surgical departments and 413 outpatient clinics in all regions of the country. The main working hypothesis of the study: during the COVID-19 pandemic, the number of hospitalizations to general surgical departments decreases, but the hospital and postoperative mortality for any reason increases both in emergency and elective surgery. RESULTS: During the pandemic, the number of hospitalizations of patients with surgical diseases decreased by 21.0%. At the same time, there was a significant increase in mortality among the entire population of patients in surgical hospitals. Surgical activity decreased, but the share of minimally invasive operations increased and there was no predicted increase in the share of late treatment in emergency surgery. The percentage of planned operations decreased by 40.8%, and the increase of postoperative mortality was registered at the same time. CONCLUSION: The presented data may be valuable for surgical care managers in emergency situations such as the COVID-19 pandemic. The long-term negative consequences of the pandemic for surgical practice are still difficult to evaluate.


Subject(s)
COVID-19 , Pandemics , Elective Surgical Procedures , Hospitals , Humans , Retrospective Studies , SARS-CoV-2
2.
AORN J ; 115(1): P4-P6, 2022 01.
Article in English | MEDLINE | ID: covidwho-1589175
5.
J Am Acad Orthop Surg ; 29(23): e1217-e1224, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1526957

ABSTRACT

INTRODUCTION: Although the pause in elective surgery was necessary to preserve healthcare resources at the height of the novel coronavirus disease 2019 (COVID-19) pandemic, recent data have highlighted the worsening pain, decline in physical activity, and increase in anxiety among cancelled total hip and knee arthroplasty patients. The purpose of this study was to evaluate the effectiveness of our staged reopening protocol and the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among elective arthroplasty patients. METHODS: We identified all elective hip and knee arthroplasty patients who underwent our universal COVID-19 testing protocol during our phased reopening between May 1, 2020, and July 21, 2020, at our institution. We recorded the SARS-CoV-2 test results of each patient along with their demographics, medical comorbidities, and symptoms at the time of testing. We followed each of these positive patients through their rescheduled cases and recorded any complications or potential SARS-CoV-2 healthcare exposures. RESULTS: Of the 2,329 patients, we identified five patients (0.21%) with a reverse transcription-polymerase chain reaction--confirmed SARS-CoV-2 positive test, none with symptoms. All patients were successfully rescheduled and underwent their elective arthroplasty procedure within 6 weeks of their original surgery date. None of these patients experienced a perioperative complication at the time of their rescheduled arthroplasty procedure. No orthopaedic surgeon or staff member caring for these patients reported a positive SARS-CoV-2 test. CONCLUSION: Our phased reopening protocol with universal preoperative virus testing was safe and identified a low incidence of SARS-CoV-2 among asymptomatic, elective arthroplasty patients at our institution. With uncertainty regarding the trajectory of the COVID-19 pandemic, we hope that this research can guide future policy decisions regarding elective surgery.


Subject(s)
Arthroplasty, Replacement, Knee , COVID-19 , Arthroplasty, Replacement, Knee/adverse effects , COVID-19 Testing , Elective Surgical Procedures , Humans , Incidence , Pandemics , SARS-CoV-2
6.
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
7.
Minerva Pediatr (Torino) ; 73(5): 460-466, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1513377

ABSTRACT

Inevitably, along with other healthcare specializations, pediatric surgery was affected by the Coronavirus disease-19 (COVID-19) pandemic. Children were reported to manifest mild to moderate symptoms and mortality was primarily observed in patients aged <1 year and having underlying comorbidities. Most of the cases were asymptomatic in children, hence, posing a challenge for pediatric surgery centers to take drastic measures to reduce the virus transmission. Telemedicine was introduced and out-patient consultations were conducted online as out-patient clinics were closed. Elective surgeries were postponed with delayed appointments while the healthcare sector was diverted towards tackling COVID-19. Case urgency was classified and triaged, leading to limited surgeries being performed only in COVID-19 negative patients following an extensive screening process. The screening process consisted of online history taking and RT-PCR tests. Newer practices such as mouth rinse, video laryngoscopy, and anesthesia were introduced to restrict patients from crying, coughing, and sneezing, as an attempt to avoid aerosolization of viral particles and safely conduct pediatric surgeries during the pandemic. Surgical trainees were also affected as the smaller number of surgeries conducted reduced the clinical experience available to medical enthusiasts. There is still room for advanced practices to be introduced in pediatric surgery and restore all kinds of surgeries to improve the quality of life of the patient.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Pandemics , Pediatrics , Surgical Procedures, Operative , Asymptomatic Infections/epidemiology , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing/methods , Child , Child, Preschool , Elective Surgical Procedures , General Surgery/education , Humans , Incidence , Infant , Patient Selection , Pediatrics/education , Preoperative Care/methods , Surgical Procedures, Operative/education , Telemedicine/organization & administration , Triage
8.
Interv Neuroradiol ; 27(1_suppl): 30-35, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1506377

ABSTRACT

At the time of this writing, the coronavirus disease 2019 pandemic continues to be a global threat, disrupting usual processes, and protocols for delivering health care around the globe. There have been significant regional and national differences in the scope and timing of these disruptions. Many hospitals were forced to temporarily halt elective neurointerventional procedures with the first wave of the pandemic in the spring of 2020, in order to prioritize allocation of resources for acutely ill patients and also to minimize coronavirus disease 2019 transmission risks to non-acute patients, their families, and health care workers. This temporary moratorium on elective neurointerventional procedures is generally credited with helping to "flatten the curve" and direct scarce resources to more acutely ill patients; however, there have been reports of some delaying seeking medical care when it was in fact urgent, and other reports of patients having elective treatment delayed with the result of morbidity and mortality. Many regions have resumed elective neurointerventional procedures, only to now watch coronavirus disease 2019 positivity rates again climbing as winter of 2020 approaches. A new wave is now forecast which may have larger volumes of hospitalized coronavirus disease 2019 patients than the earlier wave(s) and may also coincide with a wave of patients hospitalized with seasonal influenza. This paper discusses relevant and practical elements of cessation and safe resumption of nonemergent neurointerventional services in the setting of a pandemic.


Subject(s)
COVID-19 , Pandemics , Delivery of Health Care , Elective Surgical Procedures , Humans , SARS-CoV-2
9.
Anaesthesia ; 77(1): 111-112, 2022 01.
Article in English | MEDLINE | ID: covidwho-1501368
11.
Turk J Ophthalmol ; 51(5): 269-281, 2021 10 26.
Article in English | MEDLINE | ID: covidwho-1497595

ABSTRACT

Objectives: To investigate the effect of the novel coronavirus disease 2019 (COVID-19) pandemic on the clinical practice of ophthalmologists in our country. Materials and Methods: A questionnaire consisting of 22 questions was delivered to 250 ophthalmologists via e-mail and a smartphone messaging application. A total of 113 ophthalmologists completed the survey. The questions included the participants' demographic data (age, years in practice, institution, and city), changes in their working conditions and institutional preventive measures implemented during the pandemic, their personal COVID-19 experiences, the prevalence of telemedicine applications, and their attitudes toward these practices. Results: Nearly half (47.8%) of the 113 ophthalmologists were 36 to 45 years old. In terms of years in practice, the largest proportion of respondents (28.3%) had 6-10 years of experience. Most of the participants worked in private/foundation universities (37.2%), while 22.1% worked in education and research clinics. Participants working at public universities most often reported that they or a close contact had to work in COVID wards (89.5%). Triage was performed in 51.5% of ophthalmology outpatient clinics, with 88.0% of these participants reporting that patients with fever, cough, or dyspnea were directed to the pandemic clinic without ophthalmological examination. All participants working in public hospitals, education and research clinics, and public university hospitals had postponed elective surgeries, whereas 12.5% of those working in private practice and 20.5% of those working in private/foundation universities reported that they continued elective surgeries. While 80.8% of the participants did not conduct online interviews or examinations, 40.4% stated that they considered telemedicine applications beneficial. Seventy-seven percent of participants expressed concern about a decrease in their income during the pandemic, with this being especially common among participants working in private practice (87.5%) and private/foundation university hospitals (85.7%). Conclusion: Ophthalmologists across our country have been affected by this pandemic at a level that will change their clinical approach. We think that ophthalmologists impacted by the difficulty of providing personal protective equipment and economic concerns should be supported more during the pandemic.


Subject(s)
COVID-19/epidemiology , Ophthalmologists/statistics & numerical data , Ophthalmology/trends , Practice Patterns, Physicians'/statistics & numerical data , SARS-CoV-2 , Adult , Aged , Delivery of Health Care , Elective Surgical Procedures/statistics & numerical data , Female , Health Surveys , Hospitals, Private , Hospitals, Public , Humans , Male , Middle Aged , Ophthalmologists/psychology , Patient Care , Personal Protective Equipment/statistics & numerical data , Surveys and Questionnaires , Telemedicine , Turkey/epidemiology
12.
Orv Hetil ; 162(44): 1761-1768, 2021 10 31.
Article in Hungarian | MEDLINE | ID: covidwho-1496600

ABSTRACT

Összefoglaló. Bevezetés: 2020 elso negyedévében a koronavírus gyors terjedése, az általa okozott betegségek súlyos következményei miatt világszerte, így hazánkban is megváltozott az egészségügyi ellátás. Közleményünkben bemutatjuk, hogyan befolyásolták egy fovárosi kórház hasi sebészeti osztályának betegellátását, az ellátott esetek számát és összetételét a járvány elso, 2020-as tavaszi hulláma idején bevezetett járványügyi korlátozó intézkedések. Célkituzés: Célunk az volt, hogy adatokkal összehasonlítsuk 2021., 2020. és 2019. április sebészeti fekvobeteg-ellátásának jellemzoit osztályunkon. Módszer: A 2019. április 1. és 30., 2020. április 1. és 30. és 2021. április 1. és 30. közötti idoszakokban a fovárosi Bajcsy-Zsilinszky Kórház Sebészeti, Érsebészeti és Mellkassebészeti Osztályán az általános sebészeti fekvobeteg-ellátás keretében végzett hasi sebészeti mutéti beavatkozások adatait hasonlítottuk össze. Az adatokat MS Excel és SPSS (25. verzió) programokkal vizsgáltuk, és statisztikai elemzéseket végeztünk. Eredmények: A bevonási kritériumoknak 197 eset felelt meg 2019 áprilisában, 77 eset 2020 áprilisában és 95 eset 2021 áprilisában. Az osztályos ápolási ido 2019-ben átlagosan 4,51 nap, míg 2020-ban 6,31 nap és 2021-ben 6,29 nap volt. 2019-ben napi átlagban 2,54 akut és 6,2 tervezett mutét, 2020-ban napi 2 akut és 1 tervezett mutét, míg 2021-ben napi 2,8 akut és 0,9 tervezett mutét történt. Az 1 fore jutó kíséro betegségek száma a tervezett mutétek esetében 2019-ben 1,69 volt, míg 2020-ban 2,97, 2021-ben pedig 2,74. Az akut mutétre került betegek kíséro betegségeinek eloszlása szignifikánsan eltért, 1 betegre 2019-ben átlagosan 2,5, 2020-ban 3,75, míg 2021-ben 3,25 kíséro betegség jutott. Az akut sebészeti ellátáson átesett betegek halálozása 2019-ben 11,8%, 2020-ban 13,33%, 2021-ben 15,66% volt. Következtetés: A COVID-19-járvány miatt bevezetett járványügyi intézkedések velejárója volt, hogy hasi sebészeti osztályunkon lényegesen kevesebb elektív mutétet végeztünk. A sürgosséggel ellátott páciensek kíséro betegségeinek száma szignifikánsan emelkedett, valószínuleg ezzel magyarázható a halálesetek számának párhuzamos emelkedése. Orv Hetil. 2021; 162(44): 1761-1768. INTRODUCTION: Due to the rapid spread of the coronavirus and the serious consequences of the diseases, the organization of healthcare worldwide changed in the first quarter of 2020. We show effects of restriction due to protection against the first (April 2020) wave of coronavirus in our surgery care. OBJECTIVE: The aim of this study was to compare characteristics of general surgical inpatient care in April 2020 and April 2021 with April 2019 by the hospital database. METHOD: We compared general surgical data of April 2021, 2020, and 2019 from the medical informatic system at the General, Vascular and Thoracal Surgery Department of the Bajcsy-Zsilinszky Hospital in Budapest. The data were analyzed with MS Excel and SPSS (version 25) programs. RESULTS: Study inclusion criteria met with 197 cases from April 2019, 77 cases from April 2020, and 95 cases from April 2021. Length of stay at surgical department was average 4.51 days in 2019, 6.31 days in 2020, and 6.29 days in 2021. In 2019, average 2.54 urgent and 6.2 planned operations were done, in 2020 these numbers were average 2 and 1 per day and in 2021, 2.8 urgent and 0.9 planned surgical procedures were performed. The number of co-morbidities per capita in elective cases was 1.69 in 2019, 2.97 in 2020, and 2.74 in 2021. Distribution of coded co-morbidities in the case of patients with urgent surgery was significantly different between the groups, in 2019 it was 2.5, in 2020 3.75, and in 2021 3.25 per capita. Postoperative mortality at the same care of patients after urgent surgery was 11.8% in 2019, 13.33% in 2020, and 15.66% in 2021. CONCLUSION: Due to the government instructions because of COVID-19 pandemic, less elective general surgery procedures were performed in our department. Co-morbidities of patients with urgent surgery significantly increased, probably this is responsible for the increase of postoperative mortality. Orv Hetil. 2021; 162(44): 1761-1768.


Subject(s)
COVID-19 , Pandemics , Elective Surgical Procedures , Hospitals , Humans , Hungary , SARS-CoV-2
13.
In Vivo ; 35(6): 3321-3323, 2021.
Article in English | MEDLINE | ID: covidwho-1485628

ABSTRACT

BACKGROUND: Due to the high risk of COVID-19 transmission by asymptomatic patients, the aim of this study was to evaluate chest computed tomography (CT) and blood differential test as an additional COVID-19 screening tool for patients undergoing elective or urgent surgery. PATIENTS AND METHODS: The preoperative assessment of 118 patients hospitalized from June to July 2020 included real-time reverse transcriptase polymerase chain reaction RNA test before elective surgery or rapid antigen test in emergency patients. The diagnostics were supplemented by chest CT and a complete blood count with a blood smear in all patients. RESULTS: None of the hospitalized patients had molecular, serological or radiographic symptoms of COVID-19 infection. The chest CT revealed non-COVID-19 pathologies in a total of 48 patients. Leukocytosis and lymphopenia were typical of emergency patients. CONCLUSION: Routine chest CT scans have no benefit in screening for potential COVID-19 changes in asymptomatic patients. Blood differential tests are readily available, which makes them more helpful in COVID-19 screening.


Subject(s)
COVID-19 , Elective Surgical Procedures , Humans , Mass Screening , SARS-CoV-2 , Thorax
14.
J Card Surg ; 37(1): 174-175, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1483915

ABSTRACT

Deferring nonemergent cardiac surgery became the strategy of choice for several international healthcare systems afflicted by high case burdens of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) to both conserve valuable healthcare resources and protect patients from possible exposure. Missing from the available dataset to help guide policy development has been a clear understanding of the extent to which COVID-19 infection modulates cardiac surgery outcomes. In their investigation, Bonalumi et al. uncovered an inpatient COVID-19 positivity rate of almost 10 times higher than that of the general Italian population, as well as a mortality rate over 20 times higher amongst cardiac surgery patients with perioperative COVID-19 infection compared to those COVID-negative. While the summation of available evidence points to the serious consideration cardiac surgeons must give to delaying surgeries during the COVID-19 pandemic, recognition must be given to the risks that postponing cardiac surgery may have on patient outcomes. Emerging data is beginning to demonstrate the efficacy of vaccination in preventing postoperative COVID-19 infection and morbidity.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Elective Surgical Procedures , Humans , Pandemics , SARS-CoV-2
15.
Orv Hetil ; 162(42): 1678-1686, 2021 10 17.
Article in Hungarian | MEDLINE | ID: covidwho-1477611

ABSTRACT

Összefoglaló. Bevezetés: A 2019 végén Vuhanból kiinduló, SARS-CoV-2 okozta koronavírus-járvány jelentos hatást gyakorolt életünkre. Specifikus terápia hiányában az emberek egy része alternatív gyógymódokhoz fordult. Célkituzés: Vizsgálatunk célja annak feltárása volt, milyen hatást gyakorolt a koronavírus-járvány a betegek komplementer gyógymódokhoz való viszonyulására elektív sebészeti mutétek elott. Módszer: Egy magyarországi klinika és egy városi kórház elektív sebészeti mutétre váró betegei körében végeztünk anonim kérdoíves felmérést 2020. augusztus 3. és december 18. között. 279 kérdoívet dolgoztunk fel, a válaszadási arány 69,7% volt. Eredmények: A koronavírus-járvány hatására a válaszadók 91,4%-ának nem változott meg a véleménye a nem konvencionális kezelésekrol, 8,2%-a bizakodóbban tekintett ezekre. A komplementer terápia betegségmegelozo hatása iránt a kitöltok 16,8%-a volt bizakodó, 25,4%-a elutasító, 57,7%-a nem formált véleményt. A válaszadók 24,7%-a vett igénybe élete során alternatív módszereket, a koronavírus-fertozés megelozésére csak a nyilatkozók 10%-a alkalmazna ilyen gyógymódokat. Kizárólag a pandémia hatására senki nem kezdett el komplementer gyógymódokat használni. A kérdoívet kitöltok 55,6%-a használt gyógynövénykészítményt élete során. A járvány ideje alatt a válaszadók 27,5%-a vett igénybe gyógynövénykészítményeket; a gyógymód alkalmazása és a vizsgált szociodemográfiai tényezok között nem találtunk összefüggést. A gyógynövények alkalmazása alacsonyabb mértéku volt a daganatos és a thromboemboliás betegek között. Következtetés: Vizsgálatunk alapján a komplementer gyógymódok használata feltehetoen a járvány miatt elrendelt korlátozásokból adódóan csökkent, a gyógynövények alkalmazása azonban nem változott lényegesen. A válaszadók tizede használt komplementer gyógymódot a koronavírus-fertozés megelozésére. Orv Hetil. 2021; 162(42): 1678-1686. INTRODUCTION: The coronavirus epidemic caused by SARS-CoV-2 from Wuhan at the end of 2019 had considerable impact on our lives. In the absence of specific therapy, some people have resorted to alternative therapies. OBJECTIVE: The aim of our study was to explore the effect of the coronavirus epidemic on the patients' attitudes toward complementary and alternative medicine. METHOD: We have performed anonymous questionnaire survey among patients of a Hungarian university hospital and a city hospital waiting for elective surgery between August 3, 2020 and December 18, 2020. We received 279 questionnaires, the response rate was 69.7%. RESULTS: As a result of the coronavirus epidemic, 91.4% of the respondents did not change their opinion about complementary and alternative treatments, 8.2% were more optimistic about them. 16.8% of respondents were optimistic, 25.4% rejected, and 57.7% did not form an opinion about the disease-preventing effect of complementary therapy. A quarter of respondents (24.7%) had used complementary therapies in their lifetime, with only 10% of respondents using such therapies to prevent coronavirus infection. As a result of the pandemic, no one started using complementary therapies. 55.6% of the respondents used a herbal preparation during their lifetime. In the course of the epidemic, a high proportion of respondents (27.5%) used herbal preparations; no correlation was found between the use of the treatment and the socio-demographic factors examined. The use of herbs was lower among cancer and thromboembolic patients. CONCLUSION: Based on our study, the use of complementary therapies presumably decreased due to the restrictions imposed in the epidemic, however, the use of herbs did not change significantly. One-tenth of the respondents used naturopathic cure to prevent coronavirus infection. Orv Hetil. 2021; 162(42): 1678-1686.


Subject(s)
COVID-19 , Elective Surgical Procedures , Humans , Hungary , Pandemics , SARS-CoV-2
16.
Catheter Cardiovasc Interv ; 98(4): 689-690, 2021 10.
Article in English | MEDLINE | ID: covidwho-1465534

ABSTRACT

The occurrence of same-day discharge following elective rotational atherectomy cases in England and Wales during 2007-2014 increased from approximately 7 to 36%. High-volume centers and transradial approach were associated with more likelihood of same-day discharge. As compared with patients who stayed for overnight observation following elective rotational atherectomy, those discharged the same day as the procedure had a similar rate of 30-day mortality (0.35 and 0.50%, respectively; p = 0.409).


Subject(s)
Atherectomy, Coronary , Patient Discharge , Atherectomy, Coronary/adverse effects , Elective Surgical Procedures , Humans , Pandemics , Treatment Outcome
17.
Br J Nurs ; 30(17): 1032-1038, 2021 Sep 23.
Article in English | MEDLINE | ID: covidwho-1450992

ABSTRACT

During the COVID-19 pandemic, virtual pre-assessment was introduced for all elective and semi-urgent surgeries to maintain surgical clinical services in the authors' Trust. This mainly involved telephone pre-assessments, although occasionally video technology was used. This had to be managed and maintained at a distance with little or no training or established method. This article includes experiences of staff involved in a single tertiary centre, an assessment of the pros and cons of virtual pre-assessment and concludes with a set of recommendations to enhance the utility of the service for the future.


Subject(s)
COVID-19 , Pandemics , Elective Surgical Procedures , Humans , SARS-CoV-2 , Telephone
18.
World Neurosurg ; 154: e370-e381, 2021 10.
Article in English | MEDLINE | ID: covidwho-1440404

ABSTRACT

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has considerably affected surgical practice. The present study aimed to investigate the effects of the pandemic on neurosurgical practice and the safety of the resumption of elective procedures through implementing screening protocols in a high-volume academic public center in Iran, as one of the countries severely affected by the pandemic. METHODS: This unmatched case-control study compared 2 populations of patients who underwent neurosurgical procedures between June 1, 2019 and September 1, 2019 and the same period in 2020. In the prospective part of the study, patients who underwent elective procedures were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection postoperatively to evaluate the viability of our screening protocol. RESULTS: Elective and emergency procedures showed significant reduction during the pandemic (59.4%, n = 168 vs. 71.3%, n = 380) and increase (28.7%, n = 153 vs. 40.6%, n = 115, respectively; P = 0.003). The proportional distribution of neurosurgical categories remained unchanged during the pandemic. Poisson regression showed that the reduction in total daily admissions and some categories, including spine, trauma, oncology, and infection were significantly correlated with the pandemic. Among patients who underwent elective procedures, 0 (0.0%) and 26 (16.25%) had positive test results on days 30 and 60 postoperatively, respectively. Overall mortality was comparable between the pre-COVID-19 and COVID-19 periods, yet patients with concurrent SARS-CoV-2 infection showed substantially higher mortality (65%). CONCLUSIONS: By implementing safety and screening protocols with proper resource allocation, the emergency care capacity can be maintained and the risk minimized of hospital-acquired SARS-CoV-2 infection, complications, and mortality among neurosurgical patients during the pandemic. Similarly, for elective procedures, according to available resources, hospital beds can be allocated for patients with a higher risk of delayed hospitalization and those who are concerned about the risk of hospital-acquired infection can be reassured.


Subject(s)
COVID-19/diagnosis , Elective Surgical Procedures/statistics & numerical data , Neurosurgery/statistics & numerical data , Pandemics , Adult , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19 Testing , Case-Control Studies , Elective Surgical Procedures/mortality , Feasibility Studies , Female , Hospital Mortality , Humans , Iran , Male , Middle Aged , Neurosurgical Procedures , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Prospective Studies , Tomography, X-Ray Computed , Young Adult
19.
Eur J Med Res ; 26(1): 112, 2021 Sep 23.
Article in English | MEDLINE | ID: covidwho-1438306

ABSTRACT

BACKGROUND: Patients with coronavirus disease 2019 (COVID-19) who undergo surgery have impaired postoperative outcomes and increased mortality. Consequently, elective and semi-urgent operations on the increasing number of patients severely affected by COVID-19 have been indefinitely postponed.in many countries with unclear implications on disease progression and overall survival. The purpose of this study was to evaluate whether the establishment of a standardized screening program for acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sufficient to ensure high-quality medical and surgical treatment of COVID-19 and non-COVID-19 patients while minimizing in-hospital SARS-CoV-2 transmission. METHODS: The screening program comprised polymerase chain reaction (PCR) testing of nasopharyngeal swabs and a standardized questionnaire about potential symptoms for SARS-CoV-2 infection. All elective and emergency patients admitted to the surgical department of a tertiary-care hospital center in Lower Franconia, Germany, between March and May 2020 were included and their characteristics were recorded. RESULTS: Out of the study population (n = 657), 509 patients (77.5%) had at least one risk factor for a potentially severe course of COVID-19 and 164 patients (25%) were active smokers. The average 7-day incidence in Lower Franconia was 24.0/100,000 during the observation period. Preoperative PCR testing revealed four asymptomatic positive patients out of the 657 tested patients. No postoperative SARS-CoV-2 infection or transmission could be detected. CONCLUSION: The implementation of a standardized preoperative screening program to both COVID-19 and non-COVID-19 patients can ensure high-quality surgical care while minimizing infection risk for healthcare workers and potential in-hospital transmission.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19 , Elective Surgical Procedures , Infection Control/methods , Vascular Surgical Procedures , Adult , Aged , Elective Surgical Procedures/statistics & numerical data , Female , Germany/epidemiology , Humans , Infection Control/organization & administration , Male , Middle Aged , Nasopharynx/virology , Preoperative Care , Retrospective Studies , Tertiary Care Centers , Vascular Surgical Procedures/statistics & numerical data
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