Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients.
Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients.
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DOI：
10.1186/s13037-022-00331-y
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发表时间：
2022-06-28
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
虽然可以获得由于德国新冠肺炎大流行而推迟的选择性外科手术的大量数据，但关于其对紧急程序的影响的数据有限。在这项回顾性病例对照研究中，对66家医院的德国志愿医院协会(CLINOTEL协会)的匿名病例相关常规数据进行了分析。分析消化外科手术组和选定的单次手术在新冠肺炎大流行爆发前和之后一年期间的手术量、住院死亡率和新冠肺炎患病率。分析按入院科室(直接入院或转至普外科，即初级或二级外科患者)和入院类型(选择性/急诊)进行分层。一次和二次手术总人数分别下降22.7%和11.7%。在初级外科患者中，择期手术患者(-25.6%)比急诊患者(-18.8%)减少更明显。最受影响的手术是甲状腺切除术(-30.2%)、肛门手术(-24.2%)和腹股沟疝修补术(-23.9%；均为P‘s <； 0.001)。在直肠癌手术中也观察到了下降(-9.0%，P = 0.002)，但在直肠癌手术中没有下降(-3.9%，N.S.)。初次手术的死亡率略有增加(1.3%比1.5%，P <； 0.001)，但在二次手术病例中没有增加。在普通外科患者中，新冠肺炎的一年患病率很低(0.6%)，但却是死亡率的重要驱动因素(OR = 9.63，P <； 0.001)。与前一年相比，在第一个大流行年，普通外科和内脏外科的患者数量减少了22.7%。在程序方面，选择性程序减少了14.8%，紧急程序减少了6.0%。新冠肺炎感染在普通外科患者中很少见(患病率为0.6%)，但与高死亡率(21.8%)相关。本研究不符合ICMJE对临床试验的定义，因此没有注册。网上版载有补充材料，可在10.1186/s13037-022-00331-y查阅。
While extensive data are available on the postponement of elective surgical procedures due to the COVID-19 pandemic for Germany, data on the impact on emergency procedures is limited. In this retrospective case–control study, anonymized case-related routine data of a Germany-wide voluntary hospital association (CLINOTEL association) of 66 hospitals was analyzed. Operation volumes, in-hospital mortality, and COVID-19 prevalence rates in digestive surgery procedure groups and selected single surgical procedures in the one-year periods before and after the outbreak of the COVID-19 pandemic were analyzed. The analysis was stratified by admitting department (direct admission or transfer to the general surgical department, i.e., primary or secondary surgical patients) and type of admission (elective/emergent). The total number of primary and secondary surgical patients decreased by 22.7% and 11.7%, respectively. Among primary surgical patients more pronounced reductions were observed in elective (-25.6%) than emergency cases (-18.8%). Most affected procedures were thyroidectomies (-30.2%), operations on the anus (-24.2%), and closure of abdominal hernias (-23.9%; all P’s < 0.001). Declines were also observed in colorectal (-9.0%, P = 0.002), but not in rectal cancer surgery (-3.9%, n.s.). Mortality was slightly increased in primary (1.3 vs. 1.5%, P < 0.001), but not in secondary surgical cases. The one-year prevalence of COVID-19 in general surgical patients was low (0.6%), but a significant driver of mortality (OR = 9.63, P < 0.001). Compared to the previous year period, the number of patients in general and visceral surgery decreased by 22.7% in the first pandemic year. At the procedure level, a decrease of 14.8% was observed for elective procedures and 6.0% for emergency procedures. COVID-19 infections in general surgical patients are rare (0.6% prevalence), but associated with high mortality (21.8%). The present study does not meet the ICMJE definition of a clinical trial and was therefore not registered. The online version contains supplementary material available at 10.1186/s13037-022-00331-y.
[COVID-19重症监护病房的全国性暴露模型]。
DOI：
10.1007/s00063-021-00791-7
发表时间：
2022-04
期刊：
Medizinische Klinik, Intensivmedizin und Notfallmedizin
影响因子：
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作者：
Schuppert A;Theisen S;Fränkel P;Weber-Carstens S;Karagiannidis C
通讯作者：
Karagiannidis C