Dataset Information

Impact of COVID-19 pandemic on diagnosis and surgical management of common urological conditions: results from multi-institutional database analysis from the United States.

ABSTRACT:

Objective

To determine real life impact during the first pandemic year on diagnosis and surgical management of common urological diseases and 90-day postoperative mortality following common urological surgeries.

Methods

Cross-sectional study from 2016 to 2021. We used TriNetX to obtain the data. Patients with a diagnosis of six common non-oncologic and five oncologic urologic conditions were included. Twenty-four surgical interventions were also analyzed. The total number of diagnosis and surgical procedures were compared yearly from 2016 to 2021 and Chi-square test was used for statistical analysis. Additionally, monthly changes were evaluated during the first pandemic year and a z score period time was reported. The 90-day post-operative mortality rates during the first pandemic year were compared to the preceding year.

Results

Overall, a decrease in diagnosis and surgeries were observed during the first pandemic year, with maximum drop in April 2020. Among non-oncological conditions, the decrease in diagnosis of enlarged prostate (5.3%), nephrolithiasis (9.4%), urinary incontinence (18.7%), and evaluation for male sterilization (14.8%) reached statistical significance (P < 0.05 in all). Prostate cancer was the only cancer whose diagnosis showed statistically significant decrease (6.2%, P < 0.05). The surgical case load for benign conditions showed higher reduction (13.1-25%) than for malignant conditions (5.9-16.3%). There was no change in 90-day post-operative mortality in any of the analyzed surgeries.

Conclusions

Our study showed that although healthcare delivery decreased in the first pandemic year, causing a decline in the diagnosis and surgical treatment of several diseases, surgical interventions did not increase the risk of death.

SUBMITTER: Hout M

PROVIDER: S-EPMC9526193 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Impact of COVID-19 pandemic on diagnosis and surgical management of common urological conditions: results from multi-institutional database analysis from the United States.

Hout Mohammad M Arbelaez Maria Camila Suarez MCS Nackeeran Sirpi S Blachman-Braun Ruben R Shah Khushi K Towe Maxwell M Chanamolu Dimple Kumar DK Marcovich Robert R Ramasamy Ranjith R Shah Hemendra N HN

World journal of urology 20221001 11

<h4>Objective</h4>To determine real life impact during the first pandemic year on diagnosis and surgical management of common urological diseases and 90-day postoperative mortality following common urological surgeries.<h4>Methods</h4>Cross-sectional study from 2016 to 2021. We used TriNetX to obtain the data. Patients with a diagnosis of six common non-oncologic and five oncologic urologic conditions were included. Twenty-four surgical interventions were also analyzed. The total number of diagn ...[more]

PMID: 36181552

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Project description:ImportanceThe American Academy of Ophthalmology (AAO) indicated that urgent or emergent vitreoretinal surgical procedures should continue during the coronavirus disease 2019 (COVID-19) pandemic. Although decreases in the frequency of critical procedures have been reported outside the field of ophthalmology, analyses are limited by volume, geography, and time.ObjectiveTo evaluate whether the frequency of ophthalmic surgical procedures deemed urgent or emergent by the AAO changed across the United States during the COVID-19 pandemic.Design, setting, and participantsVitreoretinal practices from 17 institutions throughout the US participated in this multicenter cross-sectional study. The frequency of 11 billed vitreoretinal Current Procedural Terminology (CPT) codes across respective weeks was obtained from each practice between January 1, 2019, and May 31, 2020. Data were clustered into intravitreal injections (code 67028), lasers and cryotherapy (codes 67141, 67145, and 67228), retinal detachment (RD) repairs (codes 67107, 67108, 67110, and 67113), and other vitrectomies (codes 67036, 67039, and 67040). Institutions were categorized by region (Northeast, Midwest, South, and West Coast), practice setting (academic [tax-exempt] or private [non-tax-exempt]), and date of respective statewide stay-at-home orders.Main outcomes and measuresNationwide changes in the frequency of billing for urgent or emergent vitreoretinal surgical procedures during the COVID-19 pandemic.ResultsA total of 526 536 CPT codes were ascertained: 483 313 injections, 19 257 lasers or cryotherapy, 14 949 RD repairs, and 9017 other vitrectomies. Relative to 2019, a weekly institutional decrease in injections was observed from March 30 to May 2, 2020, with a maximal 38.6% decrease (from a mean [SD] of 437.8 [436.3] to 273.8 [269.0] injections) from April 6 to 12, 2020 (95% CI, -259 to -69 injections; P = .002). A weekly decrease was also identified that spanned a longer interval, at least until study conclusion (March 16 to May 31, 2020), for lasers and cryotherapy, with a maximal 79.6% decrease (from a mean [SD] of 6.6 [7.7] to 1.5 [2.0] procedures) from April 6 to 12, 2020 (95% CI, -6.8 to -3.3 procedures; P < .001), for RD repairs, with a maximal 59.4% decrease (from a mean [SD] of 3.5 [4.0] to 1.6 [2.2] repairs) from April 13 to 19, 2020 (95% CI, -2.7 to -1.4 repairs; P < .001), and for other vitrectomies, with a maximal 84.3% decrease (from a mean [SD] of 3.0 [3.1] to 0.4 [0.8] other vitrectomies) from April 6 to 12, 2020 (95% CI, -3.3 to -1.8 other vitrectomies; P < .001). No differences were identified by region, setting, or state-level stay-at-home order adjustment.Conclusions and relevanceAlthough the AAO endorsed the continued performance of urgent or emergent vitreoretinal surgical procedures, the frequency of such procedures throughout the country experienced a substantial decrease that may persist after the COVID-19 pandemic's initial exponential growth phase. This decrease appears independent of region, setting, and state-level stay-at-home orders. It is unknown to what extent vitreoretinal intervention would have decreased without AAO recommendations, and how the decrease is associated with outcomes. Although safety is paramount during the COVID-19 pandemic, practices should consider prioritizing availability for managing high-acuity conditions until underlying reasons for the reduction are fully appreciated.

Dataset Information

Impact of COVID-19 pandemic on diagnosis and surgical management of common urological conditions: results from multi-institutional database analysis from the United States.

Objective

Methods

Results

Conclusions

Publications

Impact of COVID-19 pandemic on diagnosis and surgical management of common urological conditions: results from multi-institutional database analysis from the United States.

Similar Datasets

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