Anthony Tang, Hussein M Abdallah, Yue-Fang Chang, Georgios A Zenonos, Paul A Gardner, Garret W Choby, Eric W Wang, Carl H Snyderman
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There were 314 patients in the pre-COVID group and 178 patients in the COVID group. Patients in the COVID group had a higher risk analysis index (RAI) frailty score (15 ± 10 pre-COVID vs. 20 ± 9 COVID, P < 0.001) and a higher American Society of Anesthesiology (ASA) physical status score (3 or 4) (72.0% pre-COVID vs. 81.9% COVID, P = 0.02). There were significantly more macroadenoma cases (87.6% pre-COVID vs. 94.4% COVID, P = 0.02) and extrasellar surgical approaches (45.2% pre-COVID vs. 61.2% COVID, P < 0.001) during COVID. There was no significant difference in length of stay (LOS) and readmission rates between groups.</p><p><strong>Conclusions: </strong>Patients that presented during the pandemic tended to be more frail, have more comorbidities, and require additional extrasellar surgical approaches. 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引用次数: 0
摘要
目的：COVID-19大流行对患者的外科治疗造成了严重影响。本研究旨在分析大流行对垂体腺瘤患者内窥镜鼻内镜手术（EES）的影响：本研究纳入了 2015 年至 2022 年期间因垂体腺瘤而接受 EES 的患者。患者被分为COVID前组（2015年1月至2020年3月）和COVID组（2020年3月至2022年9月）。采用秩方检验、菲德尔精确检验和t检验进行单变量分析，以比较各组的情况：本研究纳入了 492 名接受垂体腺瘤 EES 治疗的患者。COVID前组有314名患者，COVID组有178名患者。COVID组患者的风险分析指数（RAI）虚弱评分较高（COVID前为15±10，COVID组为20±9，P 结论：COVID组患者的风险分析指数较低，COVID组患者的虚弱评分较高：在大流行期间就诊的患者往往更加虚弱，合并症更多，需要额外的外科手术方法。尽管临床表现和手术管理发生了变化，但在 COVID 期间，患者的住院时间和再入院率保持稳定，这支持了该手术在近期大流行期间的安全性。
Changes in pituitary adenoma patient presentation and outcomes during the COVID pandemic at a Pituitary Center of Excellence.
Purpose: The COVID-19 pandemic caused significant disruption to the surgical care of patients. The aim of this study was to analyze the impact of the pandemic on endoscopic endonasal surgery (EES) for patients with a pituitary adenoma.
Methods: Patients from 2015 to 2022 that had EES for a pituitary adenoma were included in this study. Patients were separated into pre-COVID (January 2015-March 2020) and COVID (March 2020-September 2022) groups. Univariate analysis was done using chi-square, fisher exact tests, and t-tests to compare groups.
Results: This study included 492 patients that had EES for their pituitary adenoma. There were 314 patients in the pre-COVID group and 178 patients in the COVID group. Patients in the COVID group had a higher risk analysis index (RAI) frailty score (15 ± 10 pre-COVID vs. 20 ± 9 COVID, P < 0.001) and a higher American Society of Anesthesiology (ASA) physical status score (3 or 4) (72.0% pre-COVID vs. 81.9% COVID, P = 0.02). There were significantly more macroadenoma cases (87.6% pre-COVID vs. 94.4% COVID, P = 0.02) and extrasellar surgical approaches (45.2% pre-COVID vs. 61.2% COVID, P < 0.001) during COVID. There was no significant difference in length of stay (LOS) and readmission rates between groups.
Conclusions: Patients that presented during the pandemic tended to be more frail, have more comorbidities, and require additional extrasellar surgical approaches. Despite changes in clinical presentation and operative management, the LOS and readmission rate remained stable during COVID, supporting the safety of this procedure during the recent pandemic.
期刊介绍：
Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease.
The journal considers:
Biology of Pituitary Tumors
Mechanisms of Pituitary Hormone Secretion
Regulation of Pituitary Function
Prospective Clinical Studies of Pituitary Disease
Critical Basic and Clinical Reviews
Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.
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