A Nation-wide Review of Elective Surgery and COVID-Surge Capacity
| Autor: | Brajesh K. Lal, Brian R. Englum, Douglas J. Turner, John D. Sorkin, Minerva Mayorga-Carlin, Nikhil K. Prasad, Tariq Siddiqui, Rachel Lake |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) Hospitals Veterans MEDLINE law.invention 03 medical and health sciences 0302 clinical medicine law Pandemic Medicine Humans Elective surgery Veterans Affairs Pandemics Retrospective Studies Surge Capacity business.industry Mortality rate COVID-19 Regular Article Intensive care unit United States Intensive Care Units Elective Surgical Procedures 030220 oncology & carcinogenesis Emergency medicine 030211 gastroenterology & hepatology Surgery business |
| Zdroj: | The Journal of Surgical Research |
| ISSN: | 1095-8673 0022-4804 |
| Popis: | Background The COVID-19 pandemic has resulted in over 225,000 excess deaths in the United States. A moratorium on elective surgery was placed early in the pandemic to reduce risk to patients and staff and preserve critical care resources. This report evaluates the impact of the elective surgical moratorium on case volumes and intensive care unit (ICU) bed utilization. Methods This retrospective review used a national convenience sample to correlate trends in the weekly rates of surgical cases at 170 Veterans Affairs Hospitals around the United States from January 1 to September 30, 2020 to national trends in the COVID-19 pandemic. We reviewed data on weekly number of procedures performed and ICU bed usage, stratified by level of urgency (elective, urgent, emergency), and whether an ICU bed was required within 24 hours of surgery. National data on the proportion of COVID-19 positive test results and mortality rates were obtained from the Center for Disease Control website. Results 198,911 unique surgical procedures performed during the study period. The total number of cases performed from January 1 to March 16 was 86,004 compared with 15,699 from March 17 to May 17. The reduction in volume occurred before an increase in the percentage of COVID-19 positive test results and deaths nationally. There was a 91% reduction from baseline in the number of elective surgeries performed allowing 78% of surgical ICU beds to be available for COVID-19 positive patients. Conclusion The moratorium on elective surgical cases was timely and effective in creating bed capacity for critically ill COVID-19 patients. Further analyses will allow targeted resource allocation for future pandemic planning. |
| Databáze: | OpenAIRE |
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