在COVID-19期间推迟非紧急手术的后果:加拿大阿尔伯塔省的一项基于人口的回顾性队列研究
Khara Sauro1,2, Shabnam Vatanpour3, Abigail Thomas2
1University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada kmsauro@ucalgary.ca.
BMJ open
|November 14, 2024
概括
在COVID-19期间,医疗保健系统推迟了非紧急手术,导致手术完成率和等待时间的适度变化. 资源使用减少,但死亡率增加,这表明大流行对手术患者护理的延迟影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 流行病学 流行病学
背景情况:
- 世界各地的医疗保健系统推迟了选择性手术,以管理COVID-19患者的激增.
- 这种战略性资源重新分配的目的是确保为重症监护提供充足的能力.
- 这些手术延迟对患者结果和资源利用的长期影响仍然是研究的关键领域.
研究的目的:
- 调查非紧急手术延迟对手术护理的影响.
- 分析对医疗保健资源利用的影响.
- 为了确定与在疫情期间手术完成和等待时间的变化相关的因素.
主要方法:
- 进行了以人口为基础的回顾性队列研究.
- 分析了2018年12月至2021年12月期间在加拿大阿尔伯塔省预定进行手术的成年患者的数据.
- 主要结果包括完成手术和等待时间的比例;次要结果涉及医疗保健资源使用和死亡率.
主要成果:
- 在大流行期间完成的手术较少,在第四波期间显著下降 (79%至67%).
- 完成手术的等待时间减少 (105至69天),受地理区域,COVID-19浪潮和手术类型的影响.
- 与疫情前水平相比,医疗保健资源使用量下降,而医院和全因死亡率增加.
结论:
- 观察到的手术完成和等待时间的适度变化与与流行病相关的政策保持一致.
- 减少医疗资源利用率可能表明延迟影响,可能导致患者出现更晚期的疾病.
- 需要进一步的研究才能充分了解COVID-19大流行病对长期外科护理的影响.
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