A Nation-Wide Review of Elective Surgery and COVID-Surge Capacity.
A Nation-Wide Review of Elective Surgery and COVID-Surge Capacity.
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DOI：
10.1016/j.jss.2021.05.028
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Lal BK
中科院分区：
文献类型：
--
作者：
Prasad NK;Englum BR;Turner DJ;Lake R;Siddiqui T;Mayorga-Carlin M;Sorkin JD;Lal BK
新冠肺炎大流行导致美国超过22.5万人死亡。在大流行早期暂停了选择性手术，以减少对患者和工作人员的风险并保存重症监护资源。本报告评估了选择性手术暂停对病例量和重症监护病房（ICU）床位利用率的影响。这项回顾性研究使用全国方便样本，将2020年1月1日至9月30日美国170家退伍军人事务医院每周手术病例率的趋势与COVID-19大流行的全国趋势联系起来。我们回顾了每周进行的手术次数和ICU床位使用的数据，按紧急程度（选择性、紧急、紧急）分层，以及手术24小时内是否需要ICU床位。全国COVID-19阳性检测结果比例和死亡率数据来自疾病预防控制中心网站。在研究期间进行了198,911例独特的外科手术。从1月1日到3月16日，累计确诊病例为86004例，而从3月17日到5月17日，确诊病例为15699例。数量减少发生在全国COVID-19阳性检测结果和死亡人数比例上升之前。选择性手术的数量比基线减少了91%，这使得78%的外科ICU床位可用于COVID-19阳性患者。暂停择期手术，及时有效地为新冠肺炎危重患者创造了床位。进一步的分析将有助于为今后的大流行规划分配有针对性的资源。
The COVID-19 pandemic has resulted in over 225,000 excess deaths in the United States. A moratorium on elective surgery was placed early in the pandemic to reduce risk to patients and staff and preserve critical care resources. This report evaluates the impact of the elective surgical moratorium on case volumes and intensive care unit (ICU) bed utilization. This retrospective review used a national convenience sample to correlate trends in the weekly rates of surgical cases at 170 Veterans Affairs Hospitals around the United States from January 1 to September 30, 2020 to national trends in the COVID-19 pandemic. We reviewed data on weekly number of procedures performed and ICU bed usage, stratified by level of urgency (elective, urgent, emergency), and whether an ICU bed was required within 24 hours of surgery. National data on the proportion of COVID-19 positive test results and mortality rates were obtained from the Center for Disease Control website. 198,911 unique surgical procedures performed during the study period. The total number of cases performed from January 1 to March 16 was 86,004 compared with 15,699 from March 17 to May 17. The reduction in volume occurred before an increase in the percentage of COVID-19 positive test results and deaths nationally. There was a 91% reduction from baseline in the number of elective surgeries performed allowing 78% of surgical ICU beds to be available for COVID-19 positive patients. The moratorium on elective surgical cases was timely and effective in creating bed capacity for critically ill COVID-19 patients. Further analyses will allow targeted resource allocation for future pandemic planning.
COVID-19感染潜伏期接受手术患者的临床特征和结局
影响因子：
15.1
作者：
Lei, Shaoqing;Jiang, Fang;Xia, Zhengyuan
通讯作者：
Xia, Zhengyuan
影响因子：
16.9
作者：
Doglietto, Francesco;Vezzoli, Marika;Fontanella, Marco Maria
通讯作者：
Fontanella, Marco Maria