The provision of a time-critical elective surgical service during the COVID-19 Crisis: a UK experience
| Autor: | Amf Goubran, J S McGrath, Jonathan P Evans, F Khan, J R Howell, E G Burden, D J Ferguson, R W Walker, J B John |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Cardiac Catheterization Coronavirus disease 2019 (COVID-19) Adolescent media_common.quotation_subject Outcomes Hysterectomy Patient Readmission Time-to-Treatment Patient safety Young Adult Resource (project management) Arteriovenous Shunt Surgical Postoperative Complications Neoplasms Pandemic Medicine Humans Mass Screening Elective surgery Mass screening media_common Aged Aged 80 and over business.industry SARS-CoV-2 COVID-19 Time critical General Medicine Middle Aged medicine.disease United Kingdom Hospitalization Ambulatory Surgical Procedures Elective Surgical Procedures Service (economics) COVID-19 Nucleic Acid Testing Surgical Procedures Operative Urologic Surgical Procedures Surgery Female Medical emergency business human activities Delivery of Health Care |
| Zdroj: | Ann R Coll Surg Engl |
| ISSN: | 1478-7083 |
| Popis: | Introduction With the emergence of the COVID-19 pandemic, all elective surgery was temporarily suspended in the UK, allowing for diversion of resource to manage the anticipated surge of critically unwell patients. Continuing to deliver time-critical surgical care is important to avoid excess morbidity and mortality from pathologies unrelated to COVID-19. We describe the implementation and short-term surgical outcomes from a system to deliver time-critical elective surgical care to patients during the COVID-19 pandemic. Materials and methods A protocol for the prioritisation and safe delivery of time-critical surgery at a COVID-19 ‘clean’ site was implemented at the Nuffield Health Exeter Hospital, an independent sector hospital in the southwest of England. Outcomes to 30 days postoperatively were recorded, including unplanned admissions after daycase surgery, readmissions and complications, as well as the incidence of perioperative COVID-19 infection in patients and staff. Results A total of 128 surgical procedures were performed during a 31-day period by a range of specialties including breast, plastics, urology, gynaecology, vascular and cardiology. There was one unplanned admission and and two readmissions. Six complications were identified, and all were Clavien-Dindo grade 1 or 2. All 128 patients had preoperative COVID-19 swabs, one of which was positive and the patient had their surgery delayed. Ten patients were tested for COVID-19 postoperatively, with none testing positive. Conclusion This study has demonstrated the implementation of a safe system for delivery of time-critical elective surgical care at a COVID-19 clean site. Other healthcare providers may benefit from implementation of similar methodology as hospitals plan to restart elective surgery. |
| Databáze: | OpenAIRE |
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