Minerva surgery · 2021
The impact of COVID-19 pandemic on a tertiary referral proctology center: no one should be left behind.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Giani Iacopo, Gallo Gaetano, Grossi Ugo, Tanda Cinzia, Linari Chiara, Elbetti Claudio, Resumption of Proctology Algorithm Working Group
Аннотация
BACKGROUND: Coronavirus disease 2019 (COVID-19) has disrupted healthcare delivery. We aimed to describe a novel strategy to mitigate the impact of COVID-19 pandemic on a tertiary referral proctology center during the first wave of infection in Italy.
METHODS: All patients booked appointments at the Proctology Unit between March 9th and May 4th, 2020 were identified. Patients booked for a first visit underwent a structured remote consultation. Patients with perianal or sacrococcygeal abscesses, major anorectal bleeding, incoercible anal pain and red flags for malignancy were labelled as "non-deferrable." A flowchart was designed to comply with adequate assistance of proctologic patients. Demographics, clinical data and outcomes of in-office procedures were collected.
RESULTS: On a total of 548 booked visits, 198 (36.1%) were cancelled before remote consultation. Of the remaining 350, 112 (32.0%) attended a follow-up visit. Among 238 (68.0%) patients undergoing remote consultation, 88 (25.1%) were deemed "deferrable" and 148 (42.3%) "non-deferrable." Two (0.6%) were hospitalized for COVID-19 while waiting for an outpatient visit. Twenty-five of 88 (28.4%) deferrable patients cancelled their appointment as felt no longer necessary. A total of 45 of 148 (30.4%) non deferrable patients (mean age, 46 years; 31% females) underwent in-office procedures, most often related to anal abscess and/or fistula (48.9%). Final diagnosis of malignancy occurred in four cases. A 55% increase in the number of in-office procedures was noted compared to the previous year. None of the attending patients nor staff members resulted COVID-19 positive during the study period.
CONCLUSIONS: Despite the uncertainties accompanying the use of remote consultations in proctology, the results of this study may inform the development of strategies for restructuring activities in response to future emergencies of this magnitude.
METHODS: All patients booked appointments at the Proctology Unit between March 9th and May 4th, 2020 were identified. Patients booked for a first visit underwent a structured remote consultation. Patients with perianal or sacrococcygeal abscesses, major anorectal bleeding, incoercible anal pain and red flags for malignancy were labelled as "non-deferrable." A flowchart was designed to comply with adequate assistance of proctologic patients. Demographics, clinical data and outcomes of in-office procedures were collected.
RESULTS: On a total of 548 booked visits, 198 (36.1%) were cancelled before remote consultation. Of the remaining 350, 112 (32.0%) attended a follow-up visit. Among 238 (68.0%) patients undergoing remote consultation, 88 (25.1%) were deemed "deferrable" and 148 (42.3%) "non-deferrable." Two (0.6%) were hospitalized for COVID-19 while waiting for an outpatient visit. Twenty-five of 88 (28.4%) deferrable patients cancelled their appointment as felt no longer necessary. A total of 45 of 148 (30.4%) non deferrable patients (mean age, 46 years; 31% females) underwent in-office procedures, most often related to anal abscess and/or fistula (48.9%). Final diagnosis of malignancy occurred in four cases. A 55% increase in the number of in-office procedures was noted compared to the previous year. None of the attending patients nor staff members resulted COVID-19 positive during the study period.
CONCLUSIONS: Despite the uncertainties accompanying the use of remote consultations in proctology, the results of this study may inform the development of strategies for restructuring activities in response to future emergencies of this magnitude.