Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic

Batra, Tarun Kumar; Tilak, Mandar; Pai, Esha; Verma, Nimisha; Gupta, B. S.; Yadav, Ghanshyam; Dubey, Rajeev K.; Francis, N; Pandey, Manoj

doi:10.1016/j.ijom.2020.12.002

Cited by 10 publications

(21 citation statements)

References 14 publications

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“…In the Spanish National Health System, an observational study carried out in a tertiary hospital described a significant reduction in the total number of visits to a general trauma emergency department in 2020 ( 4 ). However, there are no data on the relative impact on the medical care of patients with maxillofacial trauma, as COVID-19 is an unexpected new disease ( 5 ), and therefore little is known about the extent to which the effects of staying home, social distancing, and quarantine measures have influenced patient management and surgical delays.…”

Section: Introductionmentioning

confidence: 99%

Impact of the coronavirus pandemic on maxillofacial trauma: A retrospective study in southern Spain

Infante-Cossio¹,

Fernandez-Mayoralas-Gomez²,

Gonzalez-Perez³

et al. 2022

Med Oral

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Background The coronavirus pandemic has impacted health systems worldwide, with Spain being one of the most affected countries. However, little is known about the extent to which the effects of staying home, social distancing, and quarantine measures have influenced the epidemiology of patients with maxillofacial trauma. The aim of this study was to analyze the impact of the coronavirus pandemic on the incidence, demographic patterns, and characteristics of maxillofacial fractures in the largest hospital in southern Spain. Material and Methods Data from patients who underwent surgery for maxillofacial fractures during the first year of the pandemic between 16 March 2020 and 14 March 2021 (pandemic group) were retrospectively compared with a control group during the equivalent period of the previous year (pre-pandemic group). The incidence was compared by weeks and by lockdown periods of the population. Demographic information, aetioloy, fracture characteristics, treatment performed, and days of preoperative stay were evaluated. Descriptive and bivariate statistics were calculated ( p <0.05). Results During the first year of the pandemic, there was a 35.2% reduction in maxillofacial fractures (n=59) compared to the pre-pandemic year (n=91, p =0.040). A significant drop was detected during the total home lockdown period of the population ( p =0.028). In the pandemic group, there was a reduction in fractures due to interpersonal aggressions, an increase in panfacial fractures, a significant increase in other non-facial injuries associated with polytrauma ( p =0.037), a higher number of open reduction procedures with internal fixation, and a significantly longer mean preoperative stay ( p =0.016). Conclusions The first pandemic year was associated with a decline in the frequency of maxillofacial trauma and a change in the pattern and characteristics of fractures. Inter-annual epidemiological knowledge of maxillofacial fractures may be useful for more efficient planning of resource allocation and surgical practice strategy during future coronavirus outbreaks and population lockdowns. Key words: SARS-CoV-2, coronavirus infection, pandemic, maxillofacial trauma, Spain.

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Section: Introductionmentioning

confidence: 99%

Impact of the coronavirus pandemic on maxillofacial trauma: A retrospective study in southern Spain

Infante-Cossio¹,

Fernandez-Mayoralas-Gomez²,

Gonzalez-Perez³

et al. 2022

Med Oral

View full text Add to dashboard Cite

show abstract

“…On 18th March, 2020, the routine health care services including cancer surgeries were halted, and hospital was dealing with COVID-19 infected patients and only emergency services were running, the hospital was converted to level 3, COVID-19 hospital. On 28th April 2020, the Department of Surgical Oncology started out patient services, from May 19, 2020 the operation rooms (ORs) were permitted to open with a de nitive protocol in place [9].…”

Section: Discussionmentioning

confidence: 99%

“…When the services were resumed in May 2020, a strict covid cancer surgery protocol was adopted by the department approved by the institution and was followed by all [9]. This essentially consisted of Covid RT-PCR testing and Chest CT for all patients before admission, holding the patients in holding area till reports were available and then moving them to wards, increasing the distance between patients in ward, use of full PPE kits by HCW, use of non-centralized air conditioners with lters, using double lters in anesthesia machines and discarding circuits after use, reduction in aerosol generating procedures and operating on ASA grade 1-3 patients etc.…”

Section: Methodsmentioning

confidence: 99%

Cancer Surgery during covid increased the patient mortality and the transmission risk to health care workers: results from a retrospective cohort study (NCT05240378)

Soni

Neville

Purwar

et al. 2022

Preprint

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Background India encountered two waves of Covid 19 pandemic with variability in its characteristics and severity. Concerns were raised over the safety of treatment and higher morbidity was predicted for oncological surgery. The present study was conducted to evaluate and compare the rate of morbidity and mortality in patients undergoing curative surgery for cancer before and during the Covid 19 pandemic. Method The prospectively obtained clinical data of 1576 patients treated between April 2019 to May 2021 was reviewed, of these 959 patients were operated before Covid 19 and 617 during the pandemic. The data on complications, deaths, confirmed or suspected Covid 19 cases and Covid 19 infection among health workers (HCW) was extracted. Results A 35% fall in number of surgeries was seen during the Covid period, significant fall was seen in genital and esophageal cancer. There was no difference in postoperative complication; however, the postoperative mortality was significantly higher. A total of 71 patients had Covid 19, of which 62 were preoperative and 9 postoperative, while 30/38 health care workers contracted Covid 19, of which 7 had the infection twice and 3 were infected after two doses of vaccination, there was no mortality in health care workers. Conclusion The present study demonstrate higher mortality rates after surgery in cancer patients, with no significant change in morbidity rates. A substantial proportion of HCWs were also infected though there was no mortality among this group, suggesting high mortality despite following the guidelines and protocols.

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“…Due to these restrictions and fear of getting infected with SARS-CoV-2 in hospitals, the access to healthcare facilities by patients was extremely affected [ 5 ]. Furthermore, many hospitals were giving priority to only essential procedures while deferring various nonessential services [ 10 ]. The patients suffering with cancer were apprehensive to report to hospitals as they were also not excluded from these restriction guidelines.…”

Section: Introductionmentioning

confidence: 99%

Cancer surgery during COVID increased the patient mortality and the transmission risk to healthcare workers: results from a retrospective cohort study (NCT05240378)

et al. 2022

View full text Add to dashboard Cite

Background India encountered two waves of COVID-19 pandemic with variability in its characteristics and severity. Concerns were raised over the safety of treatment, and higher morbidity was predicted for oncological surgery. The present study was conducted to evaluate and compare the rate of morbidity and mortality in patients undergoing curative surgery for cancer before and during the COVID-19 pandemic. Method The prospectively obtained clinical data of 1576 patients treated between April 2019 and May 2021 was reviewed; of these, 959 patients were operated before COVID-19 and 617 during the pandemic. The data on complications, deaths, confirmed or suspected COVID-19 cases, and COVID-19 infection among health workers (HCW) was extracted. Results A 35% fall in number of surgeries was seen during the COVID period; significant fall was seen in genital and esophageal cancer. There was no difference in postoperative complication; however, the postoperative mortality was significantly higher. A total of 71 patients had COVID-19, of which 62 were preoperative and 9 postoperative, while 30/38 healthcare workers contracted COVID-19, of which 7 had the infection twice and 3 were infected after two doses of vaccination; there was no mortality in healthcare workers. Conclusion The present study demonstrates higher mortality rates after surgery in cancer patients, with no significant change in morbidity rates. A substantial proportion of HCWs were also infected though there was no mortality among this group. The results suggest higher mortality in cancer patients despite following the guidelines and protocols.

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Increased tracheostomy rates in head and neck cancer surgery during the COVID-19 pandemic

Cited by 10 publications

References 14 publications

Impact of the coronavirus pandemic on maxillofacial trauma: A retrospective study in southern Spain

Impact of the coronavirus pandemic on maxillofacial trauma: A retrospective study in southern Spain

Cancer Surgery during covid increased the patient mortality and the transmission risk to health care workers: results from a retrospective cohort study (NCT05240378)

Cancer surgery during COVID increased the patient mortality and the transmission risk to healthcare workers: results from a retrospective cohort study (NCT05240378)

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