The impact of COVID-19 outbreak on urolithiasis emergency department admissions, hospitalizations and clinical management in central Italy: a multicentric analysis

Antonucci, Michele; Recupero, Salvatore; Marzio, Vittorio; Dominicis, M. De; Pinto, Francesco; Foschi, Nazario; Palermo, G.; Bassi, Pierfrancesco; Ragonese, Mauro

doi:10.1016/j.acuroe.2020.10.006

Cited by 20 publications

(25 citation statements)

References 13 publications

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“…A report 3 from three medical centres in the state of New York found an increase in paediatric perforated appendicitis compared with uncomplicated appendicitis during the surge of COVID-19 outbreak. Similarly, a number of reports have documented decreases in emergency visits for kidney stone disease, with an increase in severe presentations necessitating admission 14 , 15 . These data are consistent with the findings of the present study, where there was a moderate increase (0.7 per cent) in the category urolithiasis (N20–N23).…”

Section: Discussionmentioning

confidence: 94%

Impact of COVID-19 on surgical emergencies: nationwide analysis

et al. 2021

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Background The COVID-19 pandemic has had a major impact on healthcare in many countries. This study assessed the effect of a nationwide lockdown in France on admissions for acute surgical conditions and the subsequent impact on postoperative mortality. Methods This was an observational analytical study, evaluating data from a national discharge database that collected all discharge reports from any hospital in France. All adult patients admitted through the emergency department and requiring a surgical treatment between 17 March and 11 May 2020, and the equivalent period in 2019 were included. The primary outcome was the change in number of hospital admissions for acute surgical conditions. Mortality was assessed in the matched population, and stratified by region. Results During the lockdown period, 57 589 consecutive patients were admitted for acute surgical conditions, representing a decrease of 20.9 per cent compared with the 2019 cohort. Significant differences between regions were observed: the decrease was 15.6, 17.2, and 26.8 per cent for low-, intermediate- and high-prevalence regions respectively. The mortality rate was 1.92 per cent during the lockdown period and 1.81 per cent in 2019. In high-prevalence zones, mortality was significantly increased (odds ratio 1.22, 95 per cent c.i. 1.06 to 1.40). Conclusion A marked decrease in hospital admissions for surgical emergencies was observed during the lockdown period, with increased mortality in regions with a higher prevalence of COVID-19 infection. Health authorities should use these findings to preserve quality of care and deliver appropriate messages to the population.

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Section: Discussionmentioning

confidence: 94%

Impact of COVID-19 on surgical emergencies: nationwide analysis

et al. 2021

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“…The comparison of admission numbers only with data from 2019 harbors the possibility that the observed effects are caused by year‐dependent fluctuations in admission numbers. However, a comparison with previous year's data have also been considered a valid method of comparison in several other studies investigating changes in health care utilization during the COVID‐19 pandemic 1‐3,8‐11,13‐15,27,42‐45 …”

Section: Limitationsmentioning

confidence: 99%

Hospitalization deficit of in‐ and outpatient cases with cardiovascular diseases and utilization of cardiological interventions during the COVID‐19 pandemic: Insights from the German‐wide helios hospital network

König

Ueberham

Pellissier

et al. 2021

Clinical Cardiology

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Background Treatment numbers of various cardiovascular diseases were reduced throughout the early phase of the ongoing COVID‐19 pandemic. Aim of this study was to (a) expand previous study periods to examine the long‐term course of hospital admission numbers, (b) provide data for in‐ and outpatient care pathways, and (c) illustrate changes of numbers of cardiovascular procedures. Methods and Results Administrative data of patients with ICD‐10‐encoded primary diagnoses of cardiovascular diseases (heart failure, cardiac arrhythmias, ischemic heart disease, valvular heart disease, hypertension, peripheral vascular disease) and in‐ or outpatient treatment between March, 13th 2020 and September, 10th 2020 were analyzed and compared with 2019 data. Numbers of cardiovascular procedures were calculated using OPS‐codes. The cumulative hospital admission deficit (CumAD) was computed as the difference between expected and observed admissions for every week in 2020. In total, 80 hospitals contributed 294 361 patient cases to the database without relevant differences in baseline characteristics between the studied periods. There was a CumAD of −10% to −16% at the end of the study interval in 2020 for all disease groups driven to varying degrees by both reductions of in‐ and outpatient case numbers. The number of performed interventions was significantly reduced for all examined procedures (catheter ablations: −10%; cardiac electronic device implantations: −7%; percutaneous cardiovascular interventions: −9%; cardiovascular surgery: −15%). Conclusions This study provides data on the long‐term development of cardiovascular patient care during the COVID‐19 pandemic demonstrating a significant CumAD for several cardiovascular diseases and a concomitant performance deficit of cardiovascular interventions.

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“…Conversely, in the reopening phase, the admission rate and clinical presentations were similar to those in the same period in 2019, and the expected overload of complicated cases in the months following the lockdown was not demonstrated. 8 That said, we can assume that the COVID-19 lockdown led to an increasing rate of complicated ureteral stone disease that required more interventional procedures compared to the corresponding period in 2019. Our findings are in line with the study by Gul et al, which also demonstrated that serum creatinine levels, white blood cell counts, and number of interventional procedures were significantly higher in the COVID-19 lockdown period.…”

Section: Discussionmentioning

confidence: 99%

“…7 During the COVID-19 lockdown, there was a reduction in ED admissions for urolithiasis, associated with increased complication rates and worse clinical presentation, which led to the anticipation of a possible overload of complicated cases in the following months. 8 The reopening phase after the lockdown in Italy started gradually in May 2020. To date, no studies have evaluated the trend in ED admissions, clinical presentation, hospitalization, and treatment for upper tract stone disease during the reopening phase.…”

Section: Introductionmentioning

confidence: 99%

An Italian multicenter analysis of emergency admissions and treatment of upper tract urolithiasis during the lockdown and reopening phases of the COVID‐19 pandemic: Are we ready for a second wave of the outbreak?

et al. 2021

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Objectives: To assess if the lockdown period (March-April 2020) during the coronavirus disease-19 outbreak in Italy influenced the number, presentation, and treatment of urgent admissions to the emergency department for ureteral lithiasis, and to evaluate the same variables during the reopening phase (May-June 2020). Methods: We performed a retrospective analysis of patients admitted to the emergency department of three different hospitals (two coronavirus disease-19 hubs). Demographics and data on acute pyelonephritis, acute kidney injury, urinoma, hematuria, inpatient admission/discharge home, and type of treatment were gathered and compared with the same periods in 2019. Results: A total of 516 patients were admitted during the study period, of whom 62.4% were male. Their mean age was 58.86 AE 16.24 years. The number of admissions decreased significantly, by 51.25% (P = 0.003), during lockdown compared to 2019 (78 vs 160 admissions). The number of admissions in the reopening phase (May-June 2020) was in line with that in 2019 (n = 138). The number of hospitalizations (P = 0.005), acute obstructive pyelonephritis (P = 0.019), and complications (P = 0.02) was statistically significantly higher during lockdown compared to 2019. The increase in the rate of surgical procedures nearly reached significance (P = 0.059). The odds of having complications and being hospitalized were almost fivefold (odds ratio 4.68, 95% confidence interval 1.98-11.07) and twofold greater (odds ratio 2.39, 95% confidence interval 1.29-4.43) compared to the same period in 2019. No difference was noted between May-June 2020 and 2019. Conclusion:The coronavirus disease-19 lockdown period provoked a meaningful reduction in symptomatic ureteral lithiasis admission. Most patients presented with complicated disease, which required an increased rate of interventional procedures compared to the equivalent period in 2019. Admissions reverted to normal levels during the reopening phase.

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The impact of COVID-19 outbreak on urolithiasis emergency department admissions, hospitalizations and clinical management in central Italy: a multicentric analysis

Cited by 20 publications

References 13 publications

Impact of COVID-19 on surgical emergencies: nationwide analysis

Impact of COVID-19 on surgical emergencies: nationwide analysis

Hospitalization deficit of in‐ and outpatient cases with cardiovascular diseases and utilization of cardiological interventions during the COVID‐19 pandemic: Insights from the German‐wide helios hospital network

An Italian multicenter analysis of emergency admissions and treatment of upper tract urolithiasis during the lockdown and reopening phases of the COVID‐19 pandemic: Are we ready for a second wave of the outbreak?

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