背景2019年冠状病毒病(COVID-19)大流行的影响大大改变了支持研究生医学教育的医院的手术。我们检查了大流行对麻醉学培训计划的影响,亚专业暴露,程序技能经验,以及气道管理的方法。方法此单一中心的数据,回顾性队列研究来自机构审查委员会批准的临床数据储存库.日期范围在2020年分为以下阶段:大流行前(PP),早期大流行(EP),恢复1(R1),和恢复2(R2)。将所有时期与2019年同期的病例量进行比较,麻醉提供者类型,学员接触研究生医学教育认证委员会(ACGME)索引病例类别,气道技术,和患者变量。结果共确诊15087例,PP相为5,598(37.6%),EP阶段1,570(10.5%),R1阶段为1,451(9.7%),和6,269(42.1%)在R2阶段。与2019年同期相比,EP阶段的病例量显着减少(-55.3%;P<.001),改善但在R2阶段没有恢复到基线(-17.6%;P<.001)。与2019年儿科病例的数据相比,EP阶段ACGME所需的最少病例减少了(年龄<12岁,-72.1%;P<.001,年龄<3岁,-53.5%;P<.006)和体外循环病例(52.3%,P<.003)。在EP阶段,除移植手术外,手术亚专科病例量显着减少。到R2阶段,除整形手术外,所有亚专业卷都已恢复(14.9vs.10.5例/周;P<.006)和手术内窥镜检查(59.2vs.40例/周;P<.001)。从PP到EP阶段,视频喉镜(VL)和快速序列诱导和插管(RSII)的使用也增加了(24.6vs.79.6%;P<.001和10.3vs.分别为52.3%;P<.001),并保持升高至R2期(分别为35.2%;P<0.001和23.1%;P<.001)。结论COVID-19大流行在相对较短的时间内导致了手术病例暴露的显着变化。影响是短暂的,有足够的剩余时间来满足年度ACGME计划最低案例要求和程序经验。更长期的影响可能是转向增加VL和RSII的使用,在大流行的早期阶段变得更加普遍。
Background The impact of the coronavirus disease 2019 (COVID-19) pandemic substantially altered operations at hospitals that support graduate medical education. We examined the impact of the pandemic on an anesthesiology training program with respect to overall case volume, subspecialty exposure, procedural skill experience, and approaches to airway management. Methods Data for this single center, retrospective cohort study came from an Institutional Review Board approved repository for clinical data. Date ranges were divided into the following phases in 2020: Pre-Pandemic (PP), Early Pandemic (EP), Recovery 1 (R1), and Recovery 2 (R2). All periods were compared to the same period from 2019 for case volume, anesthesia provider type, trainee exposure to Accreditation Council for Graduate Medical Education (ACGME) index case categories, airway technique, and patient variables. Results 15,087 cases were identified, with 5,598 (37.6%) in the PP phase, 1,570 (10.5%) in the EP phase, 1,451 (9.7%) in the R1 phase, and 6,269 (42.1%) in the R2 phase. There was a significant reduction in case volume during the EP phase compared to the corresponding period in 2019 (-55.3%; P < .001) that improved but did not return to baseline by the R2 phase (-17.6%; P < .001). ACGME required minimum cases were reduced during the EP phase compared to 2019 data for pediatric cases (age < 12 y, -72.1%; P < .001 and age < 3 y, -53.5%; P < .006) and cardiopulmonary bypass cases (52.3%, P < .003). Surgical subspecialty case volumes were significantly reduced in the EP phase except for transplant surgery. By the R2 phase, all subspecialty volumes had recovered except for plastic surgery (14.9 vs. 10.5 cases/week; P < .006) and surgical endoscopy (59.2 vs. 40 cases/week; P < .001). Use of video laryngoscopy (VL) and rapid sequence induction and intubation (RSII) also increased from the PP to the EP phase (24.6 vs. 79.6%; P < .001 and 10.3 vs. 52.3%; P < .001, respectively) and remained elevated into the R2 phase (35.2%; P < 0.001 and 23.1%; P < .001, respectively). Conclusions The COVID-19 pandemic produced significant changes in surgical case exposure for a relatively short period. The impact was short-lived, with sufficient remaining time to meet the annual ACGME program minimum case requirements and procedural experiences. The longer-term impact may be a shift towards the increased use of VL and RSII, which became more prevalent during the early phase of the pandemic.