Anteby Roi, Zager Yaniv, Barash Yiftach, Nadler Roy, Cordoba Mordehay, Klang Eyal, Klein Yoram, Ram Edward, Gutman Mordechai, Horesh Nir
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Surgery and Transplantation B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Laparoendosc Adv Surg Tech A. 2020 Sep;30(9):1001-1007. doi: 10.1089/lap.2020.0465. Epub 2020 Jun 23.
Emergency departments (EDs) during the novel coronavirus disease 2019 (COVID-19) pandemic are perceived as possible sources of infection. The effects of COVID-19 on patients presenting to the hospital with surgical complaints remain uncertain. A single tertiary center retrospective study analysis compared the ED attendance rate and severity of patients with surgical complaints between March 2020 (COVID-19 outbreak) and pre-COVID-19 periods: February 2020 and the same 2 months in 2019 and 2018. Overall, 6,017 patients were included. The mean daily ED visits of patients with nontrauma surgical complaints in the COVID-19 outbreak period declined by 27%-32% ( value <.01) compared with pre-COVID-19 periods. The log number of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Israel in March 2020 was negatively correlated with the number of ED visits (Pearson's = -0.59, < .01). The proportion of patients requiring hospitalization increased by up to 8% during the outbreak period ( < .01), and there was a higher proportion of tachycardic patients (20% versus 15.5%, = .01). The percentage of visits to the ED by men declined by 5% ( < .01). The ED diagnosis distribution significantly changed during COVID-19 ( = .013), with an 84% decrease in the number of patients hospitalized for diverticular disease ( < .05). During the COVID-19 outbreak, the overall number of patients presenting at the ED with surgical complaints decreased significantly, and there was a higher admissions ratio. The extent to which the pandemic affects hospital ED attendance can help health care professionals prepare for future such events. ClinicalTrials.gov ID: NCT04338672.
在2019年新型冠状病毒病(COVID-19)大流行期间,急诊科被视为可能的感染源。COVID-19对因外科疾病主诉前来医院就诊患者的影响仍不确定。一项单中心三级回顾性研究分析比较了2020年3月(COVID-19疫情爆发)与COVID-19之前时期(2020年2月以及2019年和2018年的相同两个月)因外科疾病主诉就诊患者的急诊科就诊率和病情严重程度。总体而言,共纳入6017例患者。与COVID-19之前时期相比,COVID-19疫情爆发期间非创伤性外科疾病主诉患者的平均每日急诊科就诊次数下降了27% - 32%(P值<0.01)。2020年3月以色列确诊的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病例数的对数值与急诊科就诊次数呈负相关(Pearson相关系数r = -0.59,P < 0.01)。疫情爆发期间需要住院治疗的患者比例增加了高达8%(P < 0.01),心动过速患者的比例更高(20%对15.5%,P = 0.01)。男性到急诊科就诊的比例下降了5%(P < 0.01)。COVID-19期间急诊科诊断分布有显著变化(P = 0.013),因憩室病住院的患者数量减少了84%(P < 0.05)。在COVID-19疫情爆发期间,因外科疾病主诉到急诊科就诊的患者总数显著减少,且住院比例更高。大流行对医院急诊科就诊情况的影响程度有助于医护人员为未来此类事件做好准备。ClinicalTrials.gov标识符:NCT04338672。