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The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter

STUDY OBJECTIVE: The purpose of this study was to assess the impact of the COVID-19 pandemic on surgical volume and emergency department (ED) consults across obstetric & gynecologic (OB/GYN) services at a hospital located in the national epicenter of the pandemic. DESIGN: Retrospective cohort st...

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Autores principales: Spurlin, E.E., Han, E.S., Silver, E.R., May, B.L., Tatonetti, N.P., Hur, C., Advincula, A.P., Hur, H.C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7572079/
http://dx.doi.org/10.1016/j.jmig.2020.08.164
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author Spurlin, E.E.
Han, E.S.
Silver, E.R.
May, B.L.
Tatonetti, N.P.
Hur, C.
Advincula, A.P.
Hur, H.C.
author_facet Spurlin, E.E.
Han, E.S.
Silver, E.R.
May, B.L.
Tatonetti, N.P.
Hur, C.
Advincula, A.P.
Hur, H.C.
author_sort Spurlin, E.E.
collection PubMed
description STUDY OBJECTIVE: The purpose of this study was to assess the impact of the COVID-19 pandemic on surgical volume and emergency department (ED) consults across obstetric & gynecologic (OB/GYN) services at a hospital located in the national epicenter of the pandemic. DESIGN: Retrospective cohort study. SETTING: Tertiary-care academic medical center in a metropolitan city. PATIENTS OR PARTICIPANTS: Women undergoing OB/GYN ED consults or surgical procedures. INTERVENTIONS: March 16th institutional COVID-19 mandate to hold all elective surgeries. MEASUREMENTS AND MAIN RESULTS: The volume and types of surgical cases and ED consults were compared before and after the COVID-19 mandate. During the pandemic, the volume of ED consults and GYN surgeries significantly decreased, while OB surgeries remained stable. The average weekly case volume for ED consults, GYN surgeries, and OB surgeries were 44.8, 34.8, and 38.6 cases respectively during the “pre-COVID” timeframe (February 1(st) to March 15(th)) versus 17.8, 7.2, and 40.9 cases respectively during the “post-COVID” timeframe (March 16(th) toApril 15(th)), representing a 60.3% decrease in ED consults (p=<0.01) and a 79.3% decrease in GYN surgical volume (p=<0.01). The distribution of GYN surgical case types also changed significantly during the pandemic with higher proportions of emergent surgeries for ectopics, miscarriages, and concern for cancer (p <0.001). Alternatively, the OB surgical volume and distribution of OB surgical case types remained relatively constant. CONCLUSION: This study highlights how the pandemic has impacted the ways OB/GYN patients access and receive care. The OB surgeries remained stable during the COVID-19 pandemic reflecting the non-elective and time-sensitive nature of obstetric care. In contrast, ED consults and GYN surgeries decreased significantly. As expected, institutional policies suspending elective surgeries affected the volume and types of GYN surgeries performed during the pandemic, and the “stay-at-home” policy and personal fears of COVID-19 infection likely affected ED consult volumes.
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spelling pubmed-75720792020-10-20 The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter Spurlin, E.E. Han, E.S. Silver, E.R. May, B.L. Tatonetti, N.P. Hur, C. Advincula, A.P. Hur, H.C. J Minim Invasive Gynecol Article STUDY OBJECTIVE: The purpose of this study was to assess the impact of the COVID-19 pandemic on surgical volume and emergency department (ED) consults across obstetric & gynecologic (OB/GYN) services at a hospital located in the national epicenter of the pandemic. DESIGN: Retrospective cohort study. SETTING: Tertiary-care academic medical center in a metropolitan city. PATIENTS OR PARTICIPANTS: Women undergoing OB/GYN ED consults or surgical procedures. INTERVENTIONS: March 16th institutional COVID-19 mandate to hold all elective surgeries. MEASUREMENTS AND MAIN RESULTS: The volume and types of surgical cases and ED consults were compared before and after the COVID-19 mandate. During the pandemic, the volume of ED consults and GYN surgeries significantly decreased, while OB surgeries remained stable. The average weekly case volume for ED consults, GYN surgeries, and OB surgeries were 44.8, 34.8, and 38.6 cases respectively during the “pre-COVID” timeframe (February 1(st) to March 15(th)) versus 17.8, 7.2, and 40.9 cases respectively during the “post-COVID” timeframe (March 16(th) toApril 15(th)), representing a 60.3% decrease in ED consults (p=<0.01) and a 79.3% decrease in GYN surgical volume (p=<0.01). The distribution of GYN surgical case types also changed significantly during the pandemic with higher proportions of emergent surgeries for ectopics, miscarriages, and concern for cancer (p <0.001). Alternatively, the OB surgical volume and distribution of OB surgical case types remained relatively constant. CONCLUSION: This study highlights how the pandemic has impacted the ways OB/GYN patients access and receive care. The OB surgeries remained stable during the COVID-19 pandemic reflecting the non-elective and time-sensitive nature of obstetric care. In contrast, ED consults and GYN surgeries decreased significantly. As expected, institutional policies suspending elective surgeries affected the volume and types of GYN surgeries performed during the pandemic, and the “stay-at-home” policy and personal fears of COVID-19 infection likely affected ED consult volumes. Published by Elsevier Inc. 2020 2020-10-19 /pmc/articles/PMC7572079/ http://dx.doi.org/10.1016/j.jmig.2020.08.164 Text en Copyright © 2020 Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Spurlin, E.E.
Han, E.S.
Silver, E.R.
May, B.L.
Tatonetti, N.P.
Hur, C.
Advincula, A.P.
Hur, H.C.
The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter
title The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter
title_full The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter
title_fullStr The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter
title_full_unstemmed The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter
title_short The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter
title_sort impact of the covid-19 pandemic on obstetric and gynecologic procedures and consults at a metropolitan hospital in the epicenter
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7572079/
http://dx.doi.org/10.1016/j.jmig.2020.08.164
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