Where Have All the Emergencies Gone? The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a New York City Hospital.
Where Have All the Emergencies Gone? The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a New York City Hospital.
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DOI：
10.1016/j.jmig.2020.11.012
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发表时间：
2021-07
影响因子：
4.1
通讯作者：
Hur HC
中科院分区：
文献类型：
--
作者：
Spurlin EE;Han ES;Silver ER;May BL;Tatonetti NP;Ingram MA;Jin Z;Hur C;Advincula AP;Hur HC
本研究的目的是评估2019年冠状病毒病（COVID-19）大流行对纽约市一家医院妇产科（OB-GYN）服务的手术量和急诊科（艾德）咨询的影响。回顾性队列研究。纽约市的三级护理学术医疗中心。在2020年2月1日至2020年4月15日期间接受OB-GYN艾德咨询或手术的女性。3月16日机构暂停择期手术。在COVID-19暂停之前和之后，对手术和艾德咨询的数量和类型进行了比较。于疫情期间，每周平均艾德诊症及妇科手术量减少，而产科手术量则保持稳定。在COVID-19之前的时间范围内，OB-GYN艾德咨询、GYN手术和OB手术相对于所有艾德咨询、所有手术和所有分娩和分娩患者的比例分别为1.87%、13.8%和54.6（2月1日至3月15日）与COVID-19时间框架内的1.53%，21.3%，79.7%相比（3月16日至4月15日），表示OB-GYN艾德咨询比例无显著差异（p = 0.464）和妇科手术（p = 0.310），OB手术比例增加（p <0.002）。妇科手术病例类型的分布在大流行期间发生了显著变化，异位妊娠、流产和癌症的急诊手术比例较高（p <0.001）。或者，OB手术病例类型的分布保持相对恒定。这项研究强调了大流行如何影响OB-GYN患者获得和接受护理的方式。在疫情期间暂停择期手术的机构政策减少了妇科手术量，并影响了所进行的病例类型。产科手术量的下降并不令人满意，这反映了产科护理的非选择性和时间敏感性。在大流行期间，注意到艾德咨询的减少，这引出了一个问题：“所有的紧急情况都去了哪里？”虽然暂停选择性手术是必要的，但“选择性”妇科手术在医学上仍然适用于解决疼痛和出血等症状，并防止严重的医疗后遗症，如需要输血的严重贫血。当我们继续与COVID-19作斗争时，我们不能忽视那些被推迟护理的病人。
The purpose of this study was to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on surgical volume and emergency department (ED) consults across obstetrics-gynecology (OB-GYN) services at a New York City hospital. Retrospective cohort study. Tertiary care academic medical center in New York City. Women undergoing OB-GYN ED consults or surgeries between February 1, 2020 and April 15, 2020. March 16 institutional moratorium on elective surgeries. The volume and types of surgeries and ED consults were compared before and after the COVID-19 moratorium. During the pandemic, the average weekly volume of ED consults and gynecology (GYN) surgeries decreased, whereas obstetric (OB) surgeries remained stable. The proportions of OB-GYN ED consults, GYN surgeries, and OB surgeries relative to all ED consults, all surgeries, and all labor and delivery patients were 1.87%, 13.8%, 54.6% in the pre–COVID-19 time frame (February 1–March 15) vs 1.53%, 21.3%, 79.7% in the COVID-19 time frame (March 16–April 15), representing no significant difference in proportions of OB-GYN ED consults (p = .464) and GYN surgeries (p = .310) before and during COVID-19, with a proportionate increase in OB surgeries (p <.002). The distribution of GYN surgical case types changed significantly during the pandemic with higher proportions of emergent surgeries for ectopic pregnancies, miscarriages, and concern for cancer (p <.001). Alternatively, the OB surgery distribution of case types remained relatively constant. This study highlights how the pandemic has affected the ways that patients in OB-GYN access and receive care. Institutional policies suspending elective surgeries during the pandemic decreased GYN surgical volume and affected the types of cases performed. This decrease was not appreciated for OB surgical volume, reflecting the nonelective and time-sensitive nature of obstetric care. A decrease in ED consults was noted during the pandemic begging the question “Where have all the emergencies gone?” Although the moratorium on elective procedures was necessary, “elective” GYN surgeries remain medically indicated to address symptoms such as pain and bleeding and to prevent serious medical sequelae such as severe anemia requiring transfusion. As we continue to battle COVID-19, we must not lose sight of those patients whose care has been deferred.
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影响因子：
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作者：
Amparore, Daniele;Claps, Francesco;Campi, Riccardo
通讯作者：
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影响因子：
9.8
作者：
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DOI：
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发表时间：
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期刊：
REC-INTERVENTIONAL CARDIOLOGY
影响因子：
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通讯作者：
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影响因子：
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影响因子：
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通讯作者：
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