Statewide Examination of Access to Cancer Surgery During the COVID-19 Pandemic.
Statewide Examination of Access to Cancer Surgery During the COVID-19 Pandemic.
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DOI：
10.1016/j.jss.2022.10.022
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发表时间：
2023-06
影响因子：
2.2
通讯作者：
Odell, David D.
中科院分区：
文献类型：
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作者：
Adams, Elizabeth J.;Feinglass, Joe M.;Joung, Rachel Hae-Soo;Odell, David D.
COVID-19疫情导致包括癌症在内的多种疾病的医疗服务中断。在大流行期间，手术治疗癌症的趋势没有得到很好的描述。我们试图描述流行病与伊利诺伊州乳腺癌、结直肠癌和肺癌手术治疗之间的关系。我们进行了一项回顾性队列研究，评估伊利诺伊州医院的住院患者，这些医院提供肺癌（n = 1913例，n = 64家医院），乳腺癌（n = 910例，n = 108家医院）和结直肠癌（n = 5339例，n = 144家医院）的手术治疗。使用伊利诺伊州健康和医院协会比较医疗保健和医院数据报告服务数据库的出院数据，比较了2019年至2020年的平均每月手术病例量。我们还比较了每种癌症类型的癌症手术率，患者特征，以及三个时间段内使用Pearson卡方和ANOVA检验的医院类型。考虑了三个离散的时间段：大流行前（2019年7月至12月），主要大流行（2020年4月至6月）和大流行恢复（2020年7月至12月）。评估的医院特征包括医院类型（学术、社区、安全网）、COVID-19负担和基线癌症手术量。在伊利诺伊州，2020年的乳腺癌、结直肠癌和肺癌手术比2019年减少了2096例，癌症手术量的最大减少发生在2020年4月（结直肠癌，-48.3%;肺癌，-13.1%）和5月（乳腺癌，-45.2%）。与二零一九年相比，于疫情期间，乳癌（− 14. 6%）及结直肠癌（− 13. 8%）手术量减少，而肺癌手术则更为常见（+26. 4%）。在初次大流行或大流行恢复期接受肿瘤手术的患者中，在性别、人种、种族或保险状况方面没有发现显著差异。学术医院、COVID-19入院人数较多的医院以及基线癌症手术量较大的医院与主要流行期间癌症手术的最大减少相关（所有癌症类型，P <0. 01）。在恢复期，基线乳腺癌和肺癌手术量较大的医院与其同行相比，手术量仍然减少（P < 0.01）。COVID-19大流行与伊利诺伊州乳腺癌和结直肠癌手术的大幅减少有关，而肺癌手术则保持相对稳定。总的来说，癌症手术的净减少在恢复期没有得到弥补。学术医院、照顾更多COVID-19患者的医院以及基线手术量较大的医院最容易在大流行高峰期间受到手术率下降和处理积压病例延迟的影响。
The COVID-19 pandemic caused interruptions in the delivery of medical care across a wide range of conditions including cancer. Trends in surgical treatment for cancer during the pandemic have not been well described. We sought to characterize associations between the pandemic and access to surgical treatment for breast, colorectal, and lung cancer in Illinois. We performed a retrospective cohort study evaluating inpatient admissions at Illinois hospitals providing surgical care for lung cancer (n = 1913 cases, n = 64 hospitals), breast cancer (n = 910 cases, n = 108 hospitals), and colorectal cancer (n = 5339 cases, n = 144 hospitals). Using discharge data from the Illinois Health and Hospital Association's Comparative Health Care and Hospital Data Reporting Services database, average monthly surgical case volumes were compared from 2019 to 2020. We also compared rates of cancer surgery for each cancer type, by patient characteristics, and hospital type across the three time periods using Pearson chi-squared and ANOVA testing as appropriate. Three discrete time periods were considered: prepandemic (7-12/2019), primary pandemic (4-6/2020), and pandemic recovery (7-12/2020). Hospital characteristics evaluated included hospital type (academic, community, safety net), COVID-19 burden, and baseline cancer surgery volume. There were 2096 fewer operations performed for breast, colorectal, and lung cancer in 2020 than 2019 in Illinois, with the greatest reductions in cancer surgery volume occurring at the onset of the pandemic in April (colorectal, −48.3%; lung, −13.1%) and May (breast, −45.2%) of 2020. During the pandemic, breast (−14.6%) and colorectal (−13.8%) cancer surgery experienced reductions in volume whereas lung cancer operations were more common (+26.4%) compared to 2019. There were no significant differences noted in gender, race, ethnicity, or insurance status among patients receiving oncologic surgery during the primary pandemic or pandemic recovery periods. Academic hospitals, hospitals with larger numbers of COVID-19 admissions, and those with greater baseline cancer surgery volumes were associated with the greatest reduction in cancer surgery during the primary pandemic period (all cancer types, P < 0.01). During the recovery period, hospitals with greater baseline breast and lung cancer surgery volumes remained at reduced surgery volumes compared to their counterparts (P < 0.01). The COVID-19 pandemic was associated with significant reductions in breast and colorectal cancer operations in Illinois, while lung cancer operations remained relatively consistent. Overall, there was a net reduction in cancer surgery that was not made up during the recovery period. Academic hospitals, those caring for more COVID-19 patients, and those with greater baseline surgery volumes were most vulnerable to reduced surgery rates during peaks of the pandemic and to delays in addressing the backlog of cases.
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影响因子：
3.9
作者：
Vogel, Jon D.;Eskicioglu, Cagla;Steele, Scott R.
通讯作者：
Steele, Scott R.
影响因子：
4.2
作者：
Patt D;Gordan L;Diaz M;Okon T;Grady L;Harmison M;Markward N;Sullivan M;Peng J;Zhou A
通讯作者：
Zhou A
影响因子：
13.8
作者：
Heiden BT;Eaton DB Jr;Engelhardt KE;Chang SH;Yan Y;Patel MR;Kreisel D;Nava RG;Meyers BF;Kozower BD;Puri V
通讯作者：
Puri V
影响因子：
28.4
作者：
Bleicher RJ;Ruth K;Sigurdson ER;Beck JR;Ross E;Wong YN;Patel SA;Boraas M;Chang EI;Topham NS;Egleston BL
通讯作者：
Egleston BL
DOI：
10.1001/jamahealthforum.2021.4214
发表时间：
2021-12
期刊：
JAMA health forum
影响因子：
--
作者：
Tsai TC;Bryan AF;Rosenthal N;Zheng J;Orav EJ;Frakt AB;Figueroa JF
通讯作者：
Figueroa JF