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Title: The impact of COVID-19 pandemic on surgical care in Poland
Abstract:
Background: COVID-19 is an infectious disease caused by SARS-CoV-2[1]. The first cases of the novel coronavirus were reported in Wuhan, Hubei province, China in December 2019[3]. Since then, the virus SARS-CoV-2 rapidly spread to other countries. Causing pandemic, it became an unprecedented challenge to modern health care systems globally. One of the important aspects of the disease is increased perioperative mortality in patients suffering from COVID-19 and high level of transmission in health care institutions. Those factors compel reorganisation in the functioning of the heath care systems. The aim of the thesis is to investigate the process of remodelling various aspect of surgical care to operate in pandemic including strategies implemented in the operating theatre environment, management of surgical consultations in COVID-19 patients and general surgeons’ attitude towards working during COVID-19 pandemic. The thesis consists of three research articles: 1. How we prepared our operating theatre for patients with SARS-CoV-2 virus 2. General surgeons’ attitudes towards COVID-19. A national survey during the SARSCoV-2 virus outbreak 3. Surgical Interventions in Patients Hospitalised with COVID-19. A Review of Seven Months of Experience Working in a COVID-19 Dedicated Centre Methods: Ad 1) The article presents the process of adapting operating theatres departmen ; t to the threat caused by airborne disease and methodology of introducing correct procedures. Ad 2) Cross-sectional web-based national survey distributed to general surgeons by e-mail over a period of 7 days. Ad 3) All surgical consultations performed for patients infected with COVID-19 in a COVID dedicated hospital in a seven-month period were evaluated. Data on demographics, surgical specialty, consult reason, procedure performed, and whether it was a standard face to face or teleconsultation were gathered. 43 Results: Ad 1) To prepare for the pandemic we needed to implement strategies that would protect the health care workers, reduce in-hospital transmission, and provide optimal care for the patients. In the operating department, these preparations involve the cooperation of multiple teams and can pose significant difficulties. Here, we describe measures taken in response to the COVID-19 outbreak. These include, adjustments made in OR set- ups, modification of work ow and processes, and the introduction of adequate personal protective equipment. Ad 2) Among 304 responders, 42.6% were working in the hospital with COVID-19 patients. Three quarters of all surgeons (74.5%) were afraid of contracting the disease. While 42% expressed a fear for their own life while caring for COVID-19 patients, 90.1% were afraid of transmitting the disease to family members. Th ; e average reported level of PPE provided at the workplace was significantly higher among the group which was not afraid of contracting COVID-19 than among the group afraid of contracting COVID-19 (4.0 vs. 3.12, p = 0.02). Nearly all surgeons (93.8%) agreed that cancer surgeries should be continued during the pandemic and 49% perceived laparoscopy as a safe approach when operating on COVID-19 positive patients. Ad 3) Out of 2359 COVID-19 patients admitted to the hospital in the seven-month period, 229 (9.7%) required surgical care. Out of those 108 consultations that did not lead to surgery, 71% were managed by telemedicine. A total of 36 patients were operated on while suffering from COVID-19. Out of them, only three patients admitted primarily for COVID-19 pneumonia underwent emergency surgery. The overall mortality among those operated on was 16.7%. Conclusions Ad 1) We believe that these containment measures are required in order to provide an adequate quality of care to COVID-19 patient and to minimise the risk of cross-infection to Staff members and other patients. Ad 2) A high proportion of surgeons admitted being afraid of working during the COVID-19 pandemic, which had various implications for their attitude towards surgical practice. 44 Protecting health care workers is an important component of public health measures for addressing the epidemic. A ; d 3) Patients hospitalised with COVID-19 may require surgical care from various surgical specialties, especially during peaks of the pandemic. However, they rarely require a surgical procedure and only occasionally require major surgery. A significant portion of potentially surgical problems could be managed by teleconsultations.
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Rada Dyscypliny Nauki medyczne
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Last modified:
Jun 5, 2023
In our library since:
May 25, 2023
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http://dl.cm-uj.krakow.pl:8080/publication/4983
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| Edition name | Date |
|---|---|
| ZB-137506 | Jun 5, 2023 |
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