The Effect of Covid-19 on the Management of Acute Ureteric Colic in a Tertiary Hospital
British Journal of Surgery
; 109:vi36, 2022.
Article
in English
| EMBASE | ID: covidwho-2042555
ABSTRACT
Introduction:
The Covid-19 pandemic forced changes to care pathways. We have analysed the difference in provision of care to patients presenting with ureteric colic during the pandemic (PC) compared to a pre-pandemic cohort (PPC).Method:
A list was generated of all CT KUB scans requested in the emergency department. Imaging and notes were reviewed to identify acute ureteric colic presentations in September to December 2019 and 2020. Statistical significance was calculated using either the Student T-test or Chi-squared test.Results:
There were 92 patients in the PC, and 107 in the PPC. Primary treatment was provided for more patients during the pandemic (25% vs 10%, p<0.05), mainly by extracorporeal shockwave therapy (ESWL, 21% vs 7%, p<0.05). The rate of conservative management (64% vs 76%, p>0.05), temporising stent (11% vs 14%, p>0.05), and nephrostomy insertion (1% vs 1%, p>0.05) was similar in PC and PPC. The PC had a shorter time to intervention (17 vs 39 days, p<0.05), to ESWL (4 vs 12 days, p>0.05), to ureteroscopy (35 vs 45 days, p>0.05), and to stone passage confirmation (44 vs 91 days, p<0.05) respectively. There was no follow up for 15% and 30% respectively (p<0.05).Conclusion:
During the pandemic, a reduction in electives created capacity for urgent interventions, (21% vs 7% ESWL, 4 vs 12 waiting days). Accordingly, the stone passage confirmation time was more than halved (44 vs 91 days). In accordance with recommendations from NICE, TISU and GIRFT, this demonstrates the importance of ringfencing ESWL, particularly as we emerge from the pandemic.
adult; cohort analysis; conference abstract; conservative treatment; controlled study; coronavirus disease 2019; emergency ward; extracorporeal shock wave lithotripsy; female; follow up; human; kidney colic; major clinical study; male; nephrostomy; pandemic; shock wave therapy; statistical significance; stent; surgery; tertiary care center; ureteroscopy
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
Language:
English
Journal:
British Journal of Surgery
Year:
2022
Document Type:
Article
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