PDF(Pubmed)
Abstract：
UNASSIGNED: The COVID-19 pandemic posed a worldwide challenge, leading to radical changes in surgical services. The primary objective of the study was to assess the impact of COVID-19 on elective and emergency surgeries in a Brazilian metropolitan area. The secondary objective was to compare the postoperative hospital mortality before and during the pandemic.
UNASSIGNED: Time-series cohort study including data of all patients admitted for elective or emergency surgery at the hospitals in the Public Health System of Federal District, Brazil, between March 2018 and February 2022, using data extracted from the Hospital Information System of Brazilian Ministry of Health (SIH/DATASUS) on September 30, 2022. A causal impact analysis was used to evaluate the impact of COVID-19 on elective and emergency surgeries and hospital mortality.
UNASSIGNED: There were 174,473 surgeries during the study period. There was a reduction in overall (absolute effect per week: -227.5; 95% CI: -307.0 to -149.0), elective (absolute effect per week: -170.9; 95% CI: -232.8 to -112.0), and emergency (absolute effect per week: -57.7; 95% CI: -87.5 to -27.7) surgeries during the COVID-19 period. Comparing the surgeries performed before and after the COVID-19 onset, there was an increase in emergency surgeries (53.0% vs 68.8%, P < 0.001) and no significant hospital length of stay (P = 0.112). The effect of the COVID-19 pandemic on postoperative hospital mortality was not statistically significant (absolute effect per week: 2.1, 95% CI: -0.01 to 4.2).
UNASSIGNED: Our study showed a reduction in elective and emergency surgeries during the COVID-19 pandemic, possibly due to disruptions in surgical services. These findings highlight that it is crucial to implement effective strategies to prevent the accumulation of surgical waiting lists in times of crisis and improve outcomes for surgical patients.
UNASSIGNED: Time-series cohort study including data of all patients admitted for elective or emergency surgery at the hospitals in the Public Health System of Federal District, Brazil, between March 2018 and February 2022, using data extracted from the Hospital Information System of Brazilian Ministry of Health (SIH/DATASUS) on September 30, 2022. A causal impact analysis was used to evaluate the impact of COVID-19 on elective and emergency surgeries and hospital mortality.
UNASSIGNED: There were 174,473 surgeries during the study period. There was a reduction in overall (absolute effect per week: -227.5; 95% CI: -307.0 to -149.0), elective (absolute effect per week: -170.9; 95% CI: -232.8 to -112.0), and emergency (absolute effect per week: -57.7; 95% CI: -87.5 to -27.7) surgeries during the COVID-19 period. Comparing the surgeries performed before and after the COVID-19 onset, there was an increase in emergency surgeries (53.0% vs 68.8%, P < 0.001) and no significant hospital length of stay (P = 0.112). The effect of the COVID-19 pandemic on postoperative hospital mortality was not statistically significant (absolute effect per week: 2.1, 95% CI: -0.01 to 4.2).
UNASSIGNED: Our study showed a reduction in elective and emergency surgeries during the COVID-19 pandemic, possibly due to disruptions in surgical services. These findings highlight that it is crucial to implement effective strategies to prevent the accumulation of surgical waiting lists in times of crisis and improve outcomes for surgical patients.
摘要：
■COVID-19大流行构成了全球挑战，导致外科服务发生根本性变化。该研究的主要目的是评估COVID-19对巴西大都市地区择期手术和紧急手术的影响。次要目标是比较大流行之前和期间的术后住院死亡率。
■时间序列队列研究，包括在联邦区公共卫生系统医院接受择期或急诊手术的所有患者的数据，巴西,2018年3月至2022年2月，使用2022年9月30日从巴西卫生部医院信息系统（SIH/DATASUS）提取的数据。使用因果影响分析来评估COVID-19对择期和急诊手术以及医院死亡率的影响。
■在研究期间有174,473例手术。总体下降（每周绝对效果：-227.5；95％CI：-307.0至-149.0），选修（每周绝对效果：-170.9；95%CI：-232.8至-112.0），COVID-19期间的急诊手术（每周绝对效果：-57.7；95%CI：-87.5至-27.7）。比较COVID-19发病前后的手术，急诊手术增加了(53.0%对68.8%，P<0.001），住院时间无统计学意义（P=0.112）。COVID-19大流行对术后住院死亡率的影响无统计学意义（每周绝对效应：2.1，95％CI：-0.01至4.2）。
我们的研究表明，在COVID-19大流行期间，选择性手术和紧急手术减少，可能是由于手术服务中断。这些发现强调，实施有效的策略以防止危机时期手术等待名单的积累并改善手术患者的预后至关重要。
■时间序列队列研究，包括在联邦区公共卫生系统医院接受择期或急诊手术的所有患者的数据，巴西,2018年3月至2022年2月，使用2022年9月30日从巴西卫生部医院信息系统（SIH/DATASUS）提取的数据。使用因果影响分析来评估COVID-19对择期和急诊手术以及医院死亡率的影响。
■在研究期间有174,473例手术。总体下降（每周绝对效果：-227.5；95％CI：-307.0至-149.0），选修（每周绝对效果：-170.9；95%CI：-232.8至-112.0），COVID-19期间的急诊手术（每周绝对效果：-57.7；95%CI：-87.5至-27.7）。比较COVID-19发病前后的手术，急诊手术增加了(53.0%对68.8%，P<0.001），住院时间无统计学意义（P=0.112）。COVID-19大流行对术后住院死亡率的影响无统计学意义（每周绝对效应：2.1，95％CI：-0.01至4.2）。
我们的研究表明，在COVID-19大流行期间，选择性手术和紧急手术减少，可能是由于手术服务中断。这些发现强调，实施有效的策略以防止危机时期手术等待名单的积累并改善手术患者的预后至关重要。
