Abstract
Objective: This study aimed to reveal how surgical clinics were affected by the COVID-19 pandemic based on concrete data.
Method: In this study, the outpatient clinics of surgical branches were examined in terms of the number of presenting patients, number of visits, patient age, number of patient revisits, number of appointments made, patients’ time of arrival for their appointments, patient throughput times, number of patients that underwent surgery, and number of surgical operations performed during the COVID-19 pandemic.
Results: During the first year of the pandemic, concerning the number of presenting patients and number of visits, the most affected outpatient clinic was otorhinolaryngology and the least affected was gynecology and obstetrics. It was determined that the highest decrease in the mean age of patients presenting to outpatient clinics was in urology, and the lowest decrease in pediatric surgery. The patients who were the earliest to arrive for their appointments to undergo examinations were those that presented to the cardiovascular surgery clinic, while pediatric surgery patients arrived at the hospital closest to their appointment times. In the first year of the COVID-19 pandemic, the number of patients that underwent surgery decreased by 53% and the operations performed by 55% compared to the previous year.
Conclusion: With the effect of the pandemic, there was a decrease in the number of patients that presented to the outpatient clinics of surgical branches, number of visits to these clinics, appointments made, repeated visits, patients that underwent surgery, number of operations performed, and mean age of patients.
Supporting Institution
Yok
Project Number
Yok
Thanks
The authors thank Kerem Onur İlbaşı and Bilal Tekeci from the information technology software team for providing assistance in the organization of data and Assoc. Prof. Güven Özkaya for performing statistical analyses. The first author also thanks Prof. Levent Özdemir and Prof. Semra Alyılmaz for their academic mentorship.
References
- Referans1. Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 2 (surgical prioritisation). Al-Jabir A, Kerwan A, Nicola M, et al. 2020 Jul;79:233-248. DOI: https://doi.org/10.1016/j.ijsu.2020.05.002.
- Referans2. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Søreide K, Hallet J, Matthews JB, et al. Br J Surg. 2020 Sep;107(10):1250-1261. DOI: https://doi.org/10.1002/bjs.11670.
- Referans3. Resource requirements for reintroducing elective surgery during the COVID-19 pandemic: modelling study. Fowler AJ, Dobbs TD, Wan YI, et al. Br J Surg. 2021 Jan 27;108(1):97-103. DOI: https://doi.org/10.1093/bjs/znaa012.
- Referans4. Effect of COVID-19 on Surgical Training Across the United States: A National Survey of General Surgery Residents. Aziz H, James T, Remulla D, et al. J Surg Educ. 2021 Mar-Apr;78(2):431-439. DOI: https://doi.org/10.1016/j.jsurg.2020.07.037.
- Referans5. American College of Surgeons. Joint Statement: Roadmap for Maintaining Essential Surgery during COVID-19 Pandemic, Updated on August 10, 2020. Available from: https://www.facs.org/covid-19/clinical-guidance/roadmap-maintain-essential-surgery Date of access: 15 Kasım 2021.
- Referans6. American College of Surgeons. American College of Surgeons Recommendations Concerning Surgery Amid the COVID-19 Pandemic Resurgence, Released October 27, 2020. Available from: https://www.facs.org/-/media/files/covid19/acs_recommendations_concerning_surgery_amid_covid19_resurgence.ashx Date of access: 15 Kasım 2021.
- Referans7. American Collage of Surgeons. COVID-19: Elective Case Triage Guidelines for Surgical Care, Online March 24, 2020. Available from: https://www.facs.org/covid-19/clinical-guidance/elective-case Date of access: 15 Kasım 2021.
- Referans8. Global guidance for surgical care during the COVID-19 pandemic. COVID Surg Collaborative. Bhangu A, Lawani I, Ng-Kamstra JS, et al. Br J Surg. 2020 Aug;107(9):1097-1103. DOI: https://doi.org/10.1002/bjs.11646.
- Referans9. T.C. Sağlık Bakanlığı. COVID-19 Pandemi Döneminde Ameliyathanelerde Alınacak Enfeksiyon Kontrol Önlemleri, Güncellenme Tarihi: 27.04.2020. Available from: https://dosyahastane.saglik.gov.tr/Eklenti/165645,covid19-pandemi-doneminde-ameliyathanelerdepdf.pdf?0 Date of access: 15 Kasım 2021.
- Referans10. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi, 7 Aralık 2020, Ankara. Available from: https://covid19.saglik.gov.tr/Eklenti/39551/0/covid-19rehberigenelbilgilerepidemiyolojivetanipdf.pdf Date of access: 15 Kasım 2021.
- Referans11. TTB - COVID-19 Pandemisinde Yeniden Açılma Sürecinde Elektif Cerrahiler, 01.06.2020, Ankara. Available from: https://www.ttb.org.tr/haber_goster.php?Guid=702965ce-a438-11ea-bd3c-ba8d943d7595 Date of access: 15 Kasım 2021.
- Referans12. Türk Anestezi ve Reanimasyon Derneği. Anesteziyoloji ve Reanimasyon Uzmanları için COVID-19 Pandemisi Normalleşme Döneminde Elektif Cerrahilere Başlama Önerileri, 21 Mayıs 2020. Available from: http://www.tard.org.tr/assets/pdf/COVID-Elektif-Cerrahilere-Basslama-Kilavuzu-2.1.pdf Date of access: 15 Kasım 2021.
- Referans13. İstanbul Tıp Fakültesi Hastanesi Başhekimliği İnfeksiyon Kontrol Komitesi “Normalleşme Sürecinde Ameliyathanelerdeki Değişiklikler” konulu yazısı, 14.06.2020. Sayı:95747, İstanbul.
- Referans14. The clinical impact of the COVID-19 pandemic on daily urological practice: first 3-month multicenter results from Istanbul. Çakıcı MÇ, Temiz MZ, İplikçi A, et al. Turk J Med Sci. 2021 Jun 28;51(3):962-971. DOI: https://doi.org/10.3906/sag-2009-184.
- Referans15. Impact of COVID-19 on Orthopaedic and Trauma Service: An Epidemiological Study. Wong JSH, Cheung KMC. J Bone Joint Surg Am. 2020 Jul 15;102(14):e80. DOI: https://doi.org/10.2106/JBJS.20.00775.
- Referans16. Economic Impact of COVID-19 on a High-Volume Academic Neurosurgical Practice. Sivakanthan S, Pan J, Kim L, et al. World Neurosurg. 2020 Nov;143:e561-e566. DOI: https://doi.org/10.1016/j.wneu.2020.08.028. Epub 2020 Aug 10.
- Referans17. Establishing an Office-Based Framework for Resuming Otolaryngology Care in Academic Practice During the COVID-19 Pandemic. Pearlman AN, Tabaee A, Sclafani AP, et al. Otolaryngol Head Neck Surg. 2021 Mar;164(3):528-541. DOI: https://doi.org/10.1177/0194599820955178. Epub 2020 Sep 1.
- Referans18. What's Important: What Is Our Role in the COVID-19 Pandemic? Lockey SD. J Bone Joint Surg Am. 2020 Jun 3;102(11):931-932. DOI: https://doi.org/10.2106/JBJS.20.00444.
- Referans19. Managing COVID-19 in Surgical Systems. Brindle ME, Gawande A. Ann Surg. 2020 Jul;272(1):e1-e2. DOI: https://doi.org/10.1097/SLA.0000000000003923.
Abstract
Amaç: Pandeminin etkileri ağırlaştıkça servis yatağı, poliklinik odası ile ameliyathanelerin kullanımını azaltmak için acil önlemler devreye alınmıştır. Cerrahi kliniklerinin pandemiden nasıl etkilendiği somut verilerle ortaya konulmak istenmiştir.
Yöntem: Bu çalışmada polikliniğe başvuran hasta sayıları, polikliniğe yapılan başvuru sayıları, polikliniğe başvuran hastaların yaşları, polikliniğe yapılan mükerrer başvurular, polikliniğe alınan randevu sayıları, polikliniğe alınan randevuya geliş zamanları, poliklinik işlem süreleri, ameliyat olan hasta sayıları, yapılan ameliyat sayıları analiz edilmiştir.
Bulgular: Pandemi döneminde; polikliniklerine başvuran hasta sayıları ile bu polikliniklere yapılan başvuru sayıları açısından Kulak Burun Boğazın en fazla, Kadın Hastalıkları ve Doğumun en az etkilendiği görülmektedir. Polikliniklere başvuran hastaların yaş ortalamasındaki en fazla düşüşün üroloji hastalarında, en az düşüşün ise çocuk cerrahisinde olduğu görülmektedir. Mükerrer başvuruların en fazla azalma Kulak Burun Boğazda görülürken, en fazla artışın Göz bölümünde olduğu izlenmiştir. Branşların randevu alınan polikliniklerinin grup içerisindeki yüzdesine bakıldığında, en fazla artışın Ortopedide olduğu, en fazla azalmanın ise Kulak Burun Boğaz kliniğinde olduğu izlenmiştir. Poliklinik randevusuna en erken gelip muayene olan hastaların Kardiyovasküler Cerrahiye başvuranlar olduğu, randevu saatine en yakın muayene olanların ise Çocuk Cerrahisine başvuranların olduğu izlenmiştir. Ortopedi, poliklinikteki işlem süresinin en fazla arttığı, Göğüs Cerrahisi ise poliklinikteki işlem süresinin en fazla azaldığı kliniktir. Pandeminin etkili olduğu yılda, önceki yıla göre, ameliyat olan hastaların sayısında %53, gerçekleştirilen cerrahilerde ise %55 düşüş izlenmiştir.
Sonuç: Pandeminin etkisiyle: cerrahi branş polikliniklerine başvuran hasta, bu polikliniklere başvuru, polikliniklere alınabilen randevu, mükerrer başvuru, cerrahi branşlara ameliyat olan hasta, gerçekleşen ameliyat sayıları ile polikliniklere başvuran hastaların yaş ortalaması azalmıştır. Polikliniklerindeki işlem süreleri genel olarak artmıştır.
Project Number
Yok
References
- Referans1. Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 2 (surgical prioritisation). Al-Jabir A, Kerwan A, Nicola M, et al. 2020 Jul;79:233-248. DOI: https://doi.org/10.1016/j.ijsu.2020.05.002.
- Referans2. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Søreide K, Hallet J, Matthews JB, et al. Br J Surg. 2020 Sep;107(10):1250-1261. DOI: https://doi.org/10.1002/bjs.11670.
- Referans3. Resource requirements for reintroducing elective surgery during the COVID-19 pandemic: modelling study. Fowler AJ, Dobbs TD, Wan YI, et al. Br J Surg. 2021 Jan 27;108(1):97-103. DOI: https://doi.org/10.1093/bjs/znaa012.
- Referans4. Effect of COVID-19 on Surgical Training Across the United States: A National Survey of General Surgery Residents. Aziz H, James T, Remulla D, et al. J Surg Educ. 2021 Mar-Apr;78(2):431-439. DOI: https://doi.org/10.1016/j.jsurg.2020.07.037.
- Referans5. American College of Surgeons. Joint Statement: Roadmap for Maintaining Essential Surgery during COVID-19 Pandemic, Updated on August 10, 2020. Available from: https://www.facs.org/covid-19/clinical-guidance/roadmap-maintain-essential-surgery Date of access: 15 Kasım 2021.
- Referans6. American College of Surgeons. American College of Surgeons Recommendations Concerning Surgery Amid the COVID-19 Pandemic Resurgence, Released October 27, 2020. Available from: https://www.facs.org/-/media/files/covid19/acs_recommendations_concerning_surgery_amid_covid19_resurgence.ashx Date of access: 15 Kasım 2021.
- Referans7. American Collage of Surgeons. COVID-19: Elective Case Triage Guidelines for Surgical Care, Online March 24, 2020. Available from: https://www.facs.org/covid-19/clinical-guidance/elective-case Date of access: 15 Kasım 2021.
- Referans8. Global guidance for surgical care during the COVID-19 pandemic. COVID Surg Collaborative. Bhangu A, Lawani I, Ng-Kamstra JS, et al. Br J Surg. 2020 Aug;107(9):1097-1103. DOI: https://doi.org/10.1002/bjs.11646.
- Referans9. T.C. Sağlık Bakanlığı. COVID-19 Pandemi Döneminde Ameliyathanelerde Alınacak Enfeksiyon Kontrol Önlemleri, Güncellenme Tarihi: 27.04.2020. Available from: https://dosyahastane.saglik.gov.tr/Eklenti/165645,covid19-pandemi-doneminde-ameliyathanelerdepdf.pdf?0 Date of access: 15 Kasım 2021.
- Referans10. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi, 7 Aralık 2020, Ankara. Available from: https://covid19.saglik.gov.tr/Eklenti/39551/0/covid-19rehberigenelbilgilerepidemiyolojivetanipdf.pdf Date of access: 15 Kasım 2021.
- Referans11. TTB - COVID-19 Pandemisinde Yeniden Açılma Sürecinde Elektif Cerrahiler, 01.06.2020, Ankara. Available from: https://www.ttb.org.tr/haber_goster.php?Guid=702965ce-a438-11ea-bd3c-ba8d943d7595 Date of access: 15 Kasım 2021.
- Referans12. Türk Anestezi ve Reanimasyon Derneği. Anesteziyoloji ve Reanimasyon Uzmanları için COVID-19 Pandemisi Normalleşme Döneminde Elektif Cerrahilere Başlama Önerileri, 21 Mayıs 2020. Available from: http://www.tard.org.tr/assets/pdf/COVID-Elektif-Cerrahilere-Basslama-Kilavuzu-2.1.pdf Date of access: 15 Kasım 2021.
- Referans13. İstanbul Tıp Fakültesi Hastanesi Başhekimliği İnfeksiyon Kontrol Komitesi “Normalleşme Sürecinde Ameliyathanelerdeki Değişiklikler” konulu yazısı, 14.06.2020. Sayı:95747, İstanbul.
- Referans14. The clinical impact of the COVID-19 pandemic on daily urological practice: first 3-month multicenter results from Istanbul. Çakıcı MÇ, Temiz MZ, İplikçi A, et al. Turk J Med Sci. 2021 Jun 28;51(3):962-971. DOI: https://doi.org/10.3906/sag-2009-184.
- Referans15. Impact of COVID-19 on Orthopaedic and Trauma Service: An Epidemiological Study. Wong JSH, Cheung KMC. J Bone Joint Surg Am. 2020 Jul 15;102(14):e80. DOI: https://doi.org/10.2106/JBJS.20.00775.
- Referans16. Economic Impact of COVID-19 on a High-Volume Academic Neurosurgical Practice. Sivakanthan S, Pan J, Kim L, et al. World Neurosurg. 2020 Nov;143:e561-e566. DOI: https://doi.org/10.1016/j.wneu.2020.08.028. Epub 2020 Aug 10.
- Referans17. Establishing an Office-Based Framework for Resuming Otolaryngology Care in Academic Practice During the COVID-19 Pandemic. Pearlman AN, Tabaee A, Sclafani AP, et al. Otolaryngol Head Neck Surg. 2021 Mar;164(3):528-541. DOI: https://doi.org/10.1177/0194599820955178. Epub 2020 Sep 1.
- Referans18. What's Important: What Is Our Role in the COVID-19 Pandemic? Lockey SD. J Bone Joint Surg Am. 2020 Jun 3;102(11):931-932. DOI: https://doi.org/10.2106/JBJS.20.00444.
- Referans19. Managing COVID-19 in Surgical Systems. Brindle ME, Gawande A. Ann Surg. 2020 Jul;272(1):e1-e2. DOI: https://doi.org/10.1097/SLA.0000000000003923.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery |
| Journal Section | Articles |
| Authors | |
| Project Number | Yok |
| Early Pub Date | August 18, 2022 |
| Publication Date | August 31, 2022 |
| Acceptance Date | July 30, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 2 |
