1
|
Üntan İ. How did COVID-19 affect acute urolithiasis? An inner Anatolian experience. ULUS TRAVMA ACIL CER 2023; 29:780-785. [PMID: 37409918 PMCID: PMC10405038 DOI: 10.14744/tjtes.2023.36067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 07/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic has changed the number of patients seeking medical help from the emergency service (ES) with non-COVID complaints, consequencing in postponed presentations of different surgical and medical situations. Acute urinary stone disease is one of these situations and needs to be investigated in terms of the effect of COVID-19 on its presentation to the ES. METHODS In this observational, retrospective, and single-center study, we scanned each abdominopelvic computed tomography requested in ES for possible acute urolithiasis during 1 year before and after the outbreak of COVID-19. We searched to state the number of abdominopelvic computed tomographies applied and the number of ratifying urinary stone positivity. We enrolled patients' gender, age, stone location, and stone size. We also recorded C-reactive protein, leukocyte count, and creatinine and noted how long the patients suffering from pain, the duration until the intervention, and the management option selected for each case. RESULTS Total number of abdominopelvic computed tomographies performed was 1089. Of these, 517 were pre-pandemic and 572 were peri-pandemic. The number of pre and peri-pandemic stone-positive scans were, respectively, 363 (70.2%) and 379 (66.2%) (P=0.643). The females' percentage in the COVID-19 period (37.2%) was significantly lower than in the pre-pandemic period (54.3%) (P=0.013). The median size of ureter stones of the pre and peri-pandemic groups were, respectively, 4.8 mm and 3.9 mm depicting no significant difference (P=0.197). No significant difference was sighted between the pre and peri-pandemic groups concerning stone locations, blood parameters, painful duration, treatment options, and time to intervention. CONCLUSION The COVID-19 pandemic resulted in neither sicker nor fewer patients suffering from acute ureteric colic in the ES.
Collapse
Affiliation(s)
- İbrahim Üntan
- Department of Urology, Ahi Evran University Training and Research Hospital, Kirsehir-Türkiye
| |
Collapse
|
2
|
Ghazwani Y, Aldarrab R, Alghafees MA, Bin Hamri S, Alrabeeah K, Alkhayal A, Aldokhel FT, Alageel AK, Alageel MK, Alosiami MQ, Alqarni AK, Noureldin YA. Trends of Acute Renal Colic During COVID-19 Lockdown: An Experience From Saudi Arabia. Cureus 2022; 14:e29481. [PMID: 36299958 PMCID: PMC9588171 DOI: 10.7759/cureus.29481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction The COVID-19 pandemic represents an unprecedented challenge for healthcare systems around the world. Saudi Arabia was one of the first countries to experience a lockdown and postponement of elective surgical procedures. The objective of this study was to assess the trends of acute renal colic presenting to our emergency department. Methods This retrospective study targeted all patients who presented with acute renal colic during the lockdown period (March 23, 2019 to June 20, 2019). Patients’ and stone data were collected. The patient’s data included age, gender, BMI, and comorbidities. Stones' data included stone size, location, side, evidence of obstruction and UTI, and planned and conducted management. Results A total of 137 patients were identified; 92 (67.2%) patients were males with a mean age of 44 ± 16 years. Positive history of urolithiasis was reported in 47 (34.3%). The most common initial investigation was non-contrast CTs (93.4%). The majority of patients had a stone size of < 10 mm (93%) and ureteric stones (81.2%). A total of 32 patients (32.4%) had evidence of UTI and 63.4% had evidence of obstruction. Most of the patients (73.7%) were offered medical expulsive therapy (MET). Only 2.2% did not receive the planned management. Conclusion The observed pattern shows that the management during the lockdown did not differ from the original recommendations. This could be due to the fact that most patients had stone sizes between 5 and 10 mm and consequently were managed by METs. Larger data need to be conducted to provide concrete evidence. Such data are relevant to provide a clear guide for management and to establish protocols for emergency lockdown situations.
Collapse
|
3
|
Byrne MHV, Georgiades F, Light A, Lovegrove CE, Dominic C, Rahman J, Kathiravelupillai S, Klatte T, Saeb‐Parsy K, Kumar R, Howles S, Stewart GD, Turney B, Wiseman O. Impact of COVID-19 on the management and outcomes of ureteric stones in the UK: a multicentre retrospective study. BJU Int 2022; 131:82-89. [PMID: 36083711 PMCID: PMC9539039 DOI: 10.1111/bju.15882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To determine if management of ureteric stones in the UK changed during the coronavirus disease 2019 (COVID-19) pandemic and whether this affected patient outcomes. PATIENTS AND METHODS We conducted a multicentre retrospective study of adults with computed tomography-confirmed ureteric stone disease at 39 UK hospitals during a pre-pandemic period (23/3/2019-22/6/2019) and a period during the pandemic (the 3-month period after the first severe acute respiratory syndrome coronavirus-2 case at individual sites). The primary outcome was success of primary treatment modality, defined as no further treatment required for the index ureteric stone. Our study protocol was published prior to data collection. RESULTS A total of 3735 patients were included (pre-pandemic 1956 patients; pandemic 1779 patients). Stone size was similar between groups (P > 0.05). During the pandemic, patients had lower hospital admission rates (pre-pandemic 54.0% vs pandemic 46.5%, P < 0.001), shorter mean length of stay (4.1 vs 3.3 days, P = 0.02), and higher rates of use of medical expulsive therapy (17.4% vs 25.4%, P < 0.001). In patients who received interventional management (pre-pandemic 787 vs pandemic 685), rates of extracorporeal shockwave lithotripsy (22.7% vs 34.1%, P < 0.001) and nephrostomy were higher (7.1% vs 10.5%, P = 0.03); and rates of ureteroscopy (57.2% vs 47.5%, P < 0.001), stent insertion (68.4% vs 54.6%, P < 0.001), and general anaesthetic (92.2% vs 76.2%, P < 0.001) were lower. There was no difference in success of primary treatment modality between patient cohorts (pre-pandemic 73.8% vs pandemic 76.1%, P = 0.11), nor when patients were stratified by treatment modality or stone size. Rates of operative complications, 30-day mortality, and re-admission and renal function at 6 months did not differ between the data collection periods. CONCLUSIONS During the COVID-19 pandemic, there were lower admission rates and fewer invasive procedures performed. Despite this, there were no differences in treatment success or outcomes. Our findings indicate that clinicians can safely adopt management strategies developed during the pandemic to treat more patients conservatively and in the community.
Collapse
Affiliation(s)
- Matthew H V Byrne
- Nuffield Department of Surgical SciencesUniversity of OxfordUK,Oxford University Hospitals NHS Foundation TrustUK
| | - Fanourios Georgiades
- Department of SurgeryUniversity of CambridgeUK,Cambridge University Hospitals NHS Foundation TrustUK
| | | | - Catherine E Lovegrove
- Nuffield Department of Surgical SciencesUniversity of OxfordUK,Oxford University Hospitals NHS Foundation TrustUK
| | - Catherine Dominic
- Barts and the London School of Medicine, Queen Mary University of LondonUK
| | | | | | - Tobias Klatte
- Department of UrologyCharité ‐ Universitätsmedizin BerlinGermany
| | | | - Rajeev Kumar
- Nuffield Department of Surgical SciencesUniversity of OxfordUK
| | - Sarah Howles
- Nuffield Department of Surgical SciencesUniversity of OxfordUK,Oxford University Hospitals NHS Foundation TrustUK
| | - Grant D Stewart
- Department of SurgeryUniversity of CambridgeUK,Cambridge University Hospitals NHS Foundation TrustUK
| | - Ben Turney
- Nuffield Department of Surgical SciencesUniversity of OxfordUK,Oxford University Hospitals NHS Foundation TrustUK
| | | | | |
Collapse
|
4
|
Alshahrani MS, Alfaraj D, AlHumaid J, Alshahrani K, Alsubaie A, Almulhim N, Althawadi D, Alam S, Alzahrani M, Alwosibai H, Alshahrani A, Makhdom R, Alkhadra F, Al-faraj S, Al-Qahtani S, AlSulaibikh A, Jumaan MA, Asonto LP, Alahmadi S, Alghamdi M, Al-Mulhim M. Prevalence, Causes, and Adverse Clinical Impact of Delayed Presentation of Non-COVID-19-Related Emergencies during the COVID-19 Pandemic: Findings from a Multicenter Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9818. [PMID: 36011457 PMCID: PMC9408350 DOI: 10.3390/ijerph19169818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Objective: The coronavirus disease (COVID-19) pandemic has disrupted healthcare systems worldwide, resulting in decreased and delayed hospital visits of patients with non-COVID-19-related acute emergencies. We evaluated the impact of the COVID-19 pandemic on the presentation and outcomes of patients with non-COVID-19-related medical and surgical emergencies. Method: All non-COVID-19-related patients hospitalized through emergency departments in three tertiary care hospitals in Saudi Arabia and Bahrain in June and July 2020 were enrolled and categorized into delayed and non-delayed groups (presentation ≥/=24 or <24 h after onset of symptom). Primary outcome was the prevalence and cause of delayed presentation; secondary outcomes included comparative 28-day clinical outcomes (i.e., 28-day mortality, intensive care unit (ICU) admission, invasive mechanical ventilation, and acute surgical interventions). Mean, median, and IQR were used to calculate the primary outcomes and inferential statistics including chi-square/Fisher exact test, t-test where appropriate were used for comparisons. Stepwise multivariate regression analysis was performed to identify the factors associated with delay in seeking medical attention. Results: In total, 24,129 patients visited emergency departments during the study period, compared to 48,734 patients in the year 2019. Of the 256 hospitalized patients with non-COVID-19-related diagnoses, 134 (52%) had delayed presentation. Fear of COVID-19 and curfew-related restrictions represented 46 (34%) and 25 (19%) of the reasons for delay. The 28-day mortality rates were significantly higher among delayed patients vs. non-delayed patients (n = 14, 10.4% vs. n = 3, 2.5%, OR: 4.628 (CI: 1.296−16.520), p = 0.038). Conclusion: More than half of hospitalized patients with non-COVID-19-related diagnoses had delayed presentation to the ED where mortality was found to be significantly higher in this group. Fear of COVID-19 and curfew restrictions were the main reasons for delaying hospital visit.
Collapse
Affiliation(s)
- Mohammed S. Alshahrani
- Emergency Medicine and Intensive Care Departments, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Dunya Alfaraj
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Jehan AlHumaid
- Preventive Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Khalid Alshahrani
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Aisha Alsubaie
- Department of Emergency, King Hamad University Hospital, Road 2835, Busaiteen P.O. Box 24343, Bahrain
| | - Nasser Almulhim
- Emergency Department, King Fahad Hospital (KFU), Hofuf 36277, Saudi Arabia
| | - Dana Althawadi
- Department of Emergency, King Hamad University Hospital, Road 2835, Busaiteen P.O. Box 24343, Bahrain
| | - Salah Alam
- Department of Emergency, King Hamad University Hospital, Road 2835, Busaiteen P.O. Box 24343, Bahrain
| | - Malak Alzahrani
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Hassan Alwosibai
- Emergency Department, King Fahad Hospital (KFU), Hofuf 36277, Saudi Arabia
| | - Abdullah Alshahrani
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Rawan Makhdom
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Faisal Alkhadra
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Sukayna Al-faraj
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Saad Al-Qahtani
- Department of Orthopedic Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Amal AlSulaibikh
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Mohammed Al Jumaan
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Laila Perlas Asonto
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Sarah Alahmadi
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Mohannad Alghamdi
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Mohammed Al-Mulhim
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| |
Collapse
|
5
|
Uimonen M, Kuitunen I, Seikkula H, Mattila VM, Ponkilainen V. Healthcare lockdown resulted in a treatment backlog in elective urological surgery during COVID-19. BJU Int 2021; 128:33-35. [PMID: 33893701 PMCID: PMC8251249 DOI: 10.1111/bju.15433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mikko Uimonen
- Department of Surgery, Central Finland Hospital Nova, Jyväskylä, Finland
| | - Ilari Kuitunen
- School of Medicine, University of Eastern Finland, Kuopio, Finland.,Mikkeli Central Hospital, Mikkeli, Finland
| | - Heikki Seikkula
- Department of Surgery, Central Finland Hospital Nova, Jyväskylä, Finland
| | - Ville M Mattila
- Department of Orthopedics, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ville Ponkilainen
- Department of Surgery, Central Finland Hospital Nova, Jyväskylä, Finland
| |
Collapse
|