Pattern of Time-to-Surgery in Patients With Breast Cancer at Different Stages of the COVID-19 Pandemic

Chen, Ruixian; Yang, Jiqiao; Zhao, Xin; Fu, Zhoukai; Zhu, Wei; Qiu, Changjian; Wu, Yunhao; Yang, Ruoning; Liu, Weijing; Huang, Yi; Chen, Jie

doi:10.3389/fonc.2021.820638

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…At the beginning of the pandemic, authorities’ temporarily halted transportation between cities and provinces to prevent the virus from spreading, which led to expected delays in diagnosis and treatment. In addition, nothing was known about the virus at the beginning of the pandemic, and fear of covid-19 caused many to voluntarily avoid social contact, which may have been the main reason for the increased time to treatment ( 22 ) .…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the time to treat breast cancer in the pandemic period: an observational study

Silva,

Castro,

Fernandes

et al. 2023

Rev. Bras. Enferm.

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Objectives: to analyze the factors associated with the time to surgical treatment for breast cancer in patients seen at a reference mastology outpatient clinic in the State of Ceará. Methods: analytical, longitudinal study with medical charts from the Mastology Outpatient Clinic of Assis Chateaubriand Maternity School. We used 140 medical charts of breast cancer patients with surgeries performed during the pandemic. Results: the study evidenced associations between schooling and shorter time to treatment in patients who underwent biopsy before the first outpatient visit (p = 0.026; OR: 0.16; CI = 0.03-0.85); in the group who had the biopsy performed by the outpatient clinic, was associated the type of tumor (p = 0.019) and neoadjuvant therapy (p = 0.000). Conclusions: the lesser educational level, tumor type, and use of neoadjuvant therapy were factors associated with the time to treatment during the pandemic period.

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Section: Discussionmentioning

confidence: 99%

Factors associated with the time to treat breast cancer in the pandemic period: an observational study

Silva,

Castro,

Fernandes

et al. 2023

Rev. Bras. Enferm.

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“…Same day discharge after mastectomy alone has become increasingly more commonplace over the years. [12][13][14] However, same day discharge after mastectomy with immediate reconstruction has been less widely researched and implemented. Albeit limited, prior studies on same day discharges following mastectomies support its feasibility and safety.…”

Section: Discussionmentioning

confidence: 99%

“…Same day discharge after mastectomy alone has become increasingly more commonplace over the years 12–14 . However, same day discharge after mastectomy with immediate reconstruction has been less widely researched and implemented.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of a same day discharge protocol in patients undergoing mastectomy and implant reconstruction

Hayes,

Miles,

Solorio

et al. 2023

World j. surg.

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BackgroundFinite hospital resources has required a closer look at resource allocation. This has prompted a shift toward same day surgeries and a focus on reducing hospital readmissions. Following the institution of a same day discharge protocol for mastectomy and mastectomy with immediate reconstruction, we sought to assess differences in the length of stay and readmission rates.MethodsThis retrospective review evaluates all cases of mastectomy with or without immediate reconstruction performed at a single high‐volume center between June 2019 and March 2021. Average length of stay, 30‐day readmission rates, Anesthesia Society Assessment class, and type of immediate reconstruction were assessed. Autologous reconstructions were excluded.ResultsA total of 413 patients underwent mastectomy with or without reconstruction (n = 148 pre protocol and n = 265 during protocol) between June 2019 and March 2021. Of those 413 patients, 180 underwent reconstruction (n = 62 pre protocol and n = 118 during protocol). The average length of stay after mastectomy following the implementation of the same day discharge protocol was decreased at 0.6 days (n = 265) compared to preimplementation at 1.02 days (n = 148), p < 0.001. The 30‐day readmission rate was not significant between the groups, p = 0.13. A total of 180 patients underwent immediate reconstruction after mastectomy. The average length of stay after mastectomy with immediate reconstruction following implementation of the same day discharge protocol was shorter than preimplementation at 1.05 days preimplementation (n = 62) versus 0.58 days following implementation (n = 118), p < 0.001; this finding was significant for both prepectoral and subpectoral implants, p < 0.001. There was no significant difference in 30‐day readmission rates between the groups with immediate reconstruction, p = 0.34.ConclusionSame day discharge for mastectomy with reconstruction is as safe as the more widely recognized same day discharge practice for patients with mastectomy alone.

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“…An important measure of the zero-COVID strategy was using universal screening for patient admissions and intensive screening from median-to high-risk regions with local outbreaks to mitigate the spread of COVID-19. Except for the suspension of hospital admissions during the initial stage of the pandemic, the prolonged waiting time was slight thereafter ( 25 ). Policy-related preoperative screening ensured a significantly lower impact on the waiting times compared to the medical resources panic caused by the outbreak ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

Dynamic monitoring revealed a slightly prolonged waiting time for total gastrectomy during the COVID-19 pandemic without increasing the short-term complications

Zheng

Ding

et al. 2022

Front. Oncol.

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We aimed to determine the pattern of delay and its effect on the short-term outcomes of total gastrectomy before and during the coronavirus disease 2019 (COVID-19) pandemic. Overlaid line graphs were used to visualize the dynamic changes in the severity of the pandemic, number of gastric cancer patients, and waiting time for a total gastrectomy. We observed a slightly longer waiting time during the pandemic (median: 28.00 days, interquartile range: 22.00–34.75) than before the pandemic (median: 25.00 days, interquartile range: 18.00–34.00; p = 0.0071). Moreover, we study the effect of delayed surgery (waiting time > 30 days) on short-term outcomes using postoperative complications, extreme value of laboratory results, and postoperative stay. In patients who had longer waiting times, we did not observe worse short-term complication rates (grade II–IV: 15% vs. 19%, p = 0.27; grade III–IV: 7.3% vs. 9.2%, p = 0.51, the short waiting group vs. the prolonged waiting group) or a higher risk of a longer POD (univariable: OR 1.09, 95% CI 0.80–1.49, p = 0.59; multivariable: OR 1.10, 95% CI 0.78–1.55, p = 0.59). Patients in the short waiting group, rather than in the delayed surgery group, had an increased risk of bleeding in analyses of laboratory results (plasma prothrombin activity, hemoglobin, and hematocrit). A slightly prolonged preoperative waiting time during COVID-19 pandemic might not influence the short-term outcomes of patients who underwent total gastrectomy.

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Pattern of Time-to-Surgery in Patients With Breast Cancer at Different Stages of the COVID-19 Pandemic

Cited by 4 publications

References 22 publications

Factors associated with the time to treat breast cancer in the pandemic period: an observational study

Factors associated with the time to treat breast cancer in the pandemic period: an observational study

Outcomes of a same day discharge protocol in patients undergoing mastectomy and implant reconstruction

Dynamic monitoring revealed a slightly prolonged waiting time for total gastrectomy during the COVID-19 pandemic without increasing the short-term complications

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