Your browser doesn't support javascript.
Cataract risk stratification and prioritisation protocol in the COVID-19 era.
Cheng, Kelvin Kw; Anderson, Martin J; Velissaris, Stavros; Moreton, Robert; Al-Mansour, Ahmed; Sanders, Roshini; Sutherland, Shona; Wilson, Peter; Blaikie, Andrew.
  • Cheng KK; Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK. kelvincheng1901@gmail.com.
  • Anderson MJ; Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.
  • Velissaris S; Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.
  • Moreton R; Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.
  • Al-Mansour A; University of Edinburgh, Edinburgh, UK.
  • Sanders R; Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.
  • Sutherland S; Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.
  • Wilson P; University of Edinburgh, Edinburgh, UK.
  • Blaikie A; Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.
BMC Health Serv Res ; 21(1): 153, 2021 Feb 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1088592
ABSTRACT

BACKGROUND:

The COVID-19 pandemic halted non-emergency surgery across Scotland. Measures to mitigate the risks of transmitting COVID-19 are creating significant challenges to restarting all surgical services safely. We describe the development of a risk stratification tool to prioritise patients for cataract surgery taking account both specific risk factors for poor outcome from COVID-19 infection as well as surgical 'need'. In addition we report the demographics and comorbidities of patients on our waiting list.

METHODS:

A prospective case review of electronic records was performed. A risk stratification tool was developed based on review of available literature on systemic risk factors for poor outcome from COVID-19 infection as well as a surgical 'need' score. Scores derived from the tool were used to generate 6 risk profile groups to allow prioritised allocation of surgery.

RESULTS:

There were 744 patients awaiting cataract surgery of which 66 (8.9 %) patients were 'shielding'. One hundred and thirty-two (19.5 %) patients had no systemic comorbidities, 218 (32.1 %) patients had 1 relevant systemic comorbidity and 316 (46.5 %) patients had 2 or more comorbidities. Five hundred and ninety patients (88.7 %) did not have significant ocular comorbidities. Using the risk stratification tool, 171 (23 %) patients were allocated in the highest 3 priority stages. Given an aging cohort with associated increase in number of systemic comorbidities, the majority of patients were in the lower priority stages 4 to 6.

CONCLUSIONS:

COVID-19 has created an urgent challenge to deal safely with cataract surgery waiting lists. This has driven the need for a prompt and pragmatic change to the way we assess risks and benefits of a previously regarded as low-risk intervention. This is further complicated by the majority of patients awaiting cataract surgery being elderly with comorbidities and at higher risk of mortality related to COVID-19. We present a pragmatic method of risk stratifying patients on waiting lists, blending an evidence-based objective assessment of risk and patient need combined with an element of shared decision-making. This has facilitated safe and successful restarting of our cataract service.
Asunto(s)

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Catarata / Extracción de Catarata / Listas de Espera / Pandemias / COVID-19 Tipo de estudio: Estudio de cohorte / Estudio experimental / Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Límite: Anciano / Femenino / Humanos / Masculino País/Región como asunto: Europa Idioma: Inglés Revista: BMC Health Serv Res Asunto de la revista: Investigación sobre Servicios de Salud Año: 2021 Tipo del documento: Artículo País de afiliación: S12913-021-06165-1

Similares

MEDLINE

...
LILACS

LIS


Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Catarata / Extracción de Catarata / Listas de Espera / Pandemias / COVID-19 Tipo de estudio: Estudio de cohorte / Estudio experimental / Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Límite: Anciano / Femenino / Humanos / Masculino País/Región como asunto: Europa Idioma: Inglés Revista: BMC Health Serv Res Asunto de la revista: Investigación sobre Servicios de Salud Año: 2021 Tipo del documento: Artículo País de afiliación: S12913-021-06165-1