在 COVID-19 中简化新斯科舍省的肺癌管理:集合分流,加快治疗性肿瘤手术。

IF 2.2 4区 医学 Q2 SURGERY Canadian Journal of Surgery Pub Date : 2024-07-04 Print Date: 2024-07-01 DOI:10.1503/cjs.013023
Pooja Patel, Rheann Brownstone, Brianne Cruickshank, Connor Garagan, Daria Manos, Daniel French, Alison Wallace, Madelaine Plourde
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引用次数: 0

摘要

背景:COVID-19大流行对加拿大肺癌诊断和治疗的影响尚不完全清楚。我们试图量化该省在大流行背景下的诊断成像量、胸外科医生转诊量、转诊后的手术时间以及治愈性手术的病理分期,并探索集合患者模式的效果,该模式的实施是为了优先考虑肺癌手术并减轻大流行的影响:我们对在 COVID-19 大流行之前(2019 年 3 月 1 日至 2020 年 2 月 29 日)和期间(2020 年 3 月 1 日至 2021 年 2 月 28 日)在新斯科舍省接受影像诊断并随后被转诊至该省唯一一家三级医疗中心的胸外科医生处接受原发性肺癌手术治疗的患者进行了一项回顾性队列研究。我们进行了一项调查,以了解患者和外科医生在使用集合患者模式管理肿瘤外科病例方面的经验:结果:与 COVID-19 前相比,COVID-19 期间胸部放射线检查和胸部计算机断层扫描的总体数量分别减少了 30.9% (p < 0.001) 和 18.7% (p = 0.002)。胸外科医生转诊、手术方式、切除范围、住院时间和病理分期没有显著差异。在 COVID-19 期间,从转诊到手术的时间明显缩短(平均 196.8 d 对 157.9 d,p = 0.04)。患者集中就诊有助于提高患者满意度:COVID-19大流行与肺癌诊断成像率和胸外科医生转诊率的降低有关。为减轻大流行对肺癌治疗的影响,采用了集合患者模式,并得到了患者的积极响应。要确定这种资源重新分配的全部效果,还需要延长研究时间。
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Streamlining lung cancer management in Nova Scotia amid COVID-19: pooled triaging for expedited curative-intent oncologic surgery.

Background: The effect of the COVID-19 pandemic on the diagnosis and management of lung cancer in Canada is not fully understood. We sought to quantify the provincial volume of diagnostic imaging, thoracic surgeon referrals, time to surgery after referral, and pathologic staging for curative surgery in the context of the pandemic, as well as explore the effect of a pooled patient model, which was implemented to prioritize surgeries for lung cancer and mitigate the effects of the pandemic.

Methods: We conducted a retrospective cohort study of patients who underwent diagnostic imaging in Nova Scotia and were subsequently referred to a thoracic surgeon at the province's only tertiary care centre for surgical management of their primary lung cancer before (Mar. 1, 2019, to Feb. 29, 2020) and during (Mar. 1, 2020, to Feb. 28, 2021) the COVID-19 pandemic. We conducted a survey to capture the patient and surgeon experience with a pooled patient model of managing surgical oncology cases.

Results: Compared with the pre-COVID-19 period, the overall volume of chest radiography and chest computed tomography decreased by 30.9% (p < 0.001) and 18.7% (p = 0.002), respectively, in the COVID-19 period. Thoracic surgeon referrals, operative approach, extent of resection, length of hospital stay, and pathologic staging did not significantly differ. Time from referral to surgery was significantly shorter during the COVID-19 period (mean 196.8 d v. 157.9 d, p = 0.04). A pooled patient approach contributed to positive patient satisfaction.

Conclusion: The COVID-19 pandemic was associated with reductions in rates of diagnostic imaging and referrals to thoracic surgeons for management of pulmonary cancer. A pooled patient model was used to mitigate the effects of the pandemic on lung cancer management and was positively received by patients. An extended study period is needed to determine the full effect of this redistribution of resources.

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来源期刊
CiteScore
3.00
自引率
8.00%
发文量
120
审稿时长
6-12 weeks
期刊介绍: The mission of CJS is to contribute to the meaningful continuing medical education of Canadian surgical specialists, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.
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