The influence of COVID-19 lockdowns on presentation with spontaneous posterior vitreous detachment to the emergency department in Italy

Zeppieri, Marco; Salvetat, Maria Letizia; Salati, Carlo

doi:10.52586/e883

Cited by 3 publications

References 38 publications

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Presentations to eye emergency departments with flashes and floaters differ dependent on incident solar radiation

et al. 2023

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Aim The aim of this retrospective review was to analyse the frequency of patients presenting with flashes and/or floaters (F/F) on bright versus dark days to the eye emergency department of a tertiary referral hospital (the Mater Misericordiae University Hospital) over a 3-year period. The diagnostic and clinical outcomes of F/F presentations were also analysed. Methods This retrospective study assessed eye casualty attendances between January 2018 and December 2020. Solar irradiation (j/cm 2 ) at ground level was retrieved from the records of Met Eireann (Irish National Meteorological Service) via their open access records. A review of electronic patient medical records using the in-house database patient centre was carried out of all patients who attended EED of during the study timeline on the 5 'brightest' and 5 'darkest' days of each year. Results Seven hundred forty patient presentations were analysed in total. Overall, 16% (n = 119) of all patients that attended EED during the timeframe of the study presented with F/F. One hundred six patients (89%) presented with floaters, 40 patients (34%) presented with flashing lights/photopsia, and 35 patients (29%) presented with both F/F. More patients presented to EED with F/F on bright days when compared with dark days (74 vs 45, p < 0.05). Eighty-nine percent of all patients with F/F presented with monocular floaters. There were more floater presentations during bright when compared with dark days (70 vs 36, p < 0.05). More patients were diagnosed with PVD on bright days when compared with those diagnosed with PVD on dark days (43vs 15, p < 0.05). More RDs were diagnosed on dark days compared with bright days (7 vs 3, p < 0.05). Conclusion This study established that F/F presentations were more likely to present during bright days when compared with dark days. The diagnosis of PVD was more common during bright days, and RDs were diagnosed significantly more frequently on dark days. Although incident solar radiation was correlated with greater floaters/PVD presentation, causation is unlikely, and the duration of PVD may have been longer in patients presenting on bright days (i.e. pseudo-sudden symptoms).

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Presentations to eye emergency departments with flashes and floaters differ dependent on incident solar radiation

et al. 2023

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Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020–2021): a scoping review

V. Carvalho,

Broekema,

Brito Fernandes

et al. 2024

BMC Emerg Med

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Background The COVID-19 pandemic severely impacted care for non-COVID patients. Performance indicators to monitor acute care, timely reported and internationally accepted, lacked during the pandemic in OECD countries. This study aims to summarize the performance indicators available in the literature to monitor changes in the quality of acute care in OECD countries during the first year and a half of the pandemic (2020-July 2021) and to assess their trends. Methods Scoping review. Search in Embase and MEDLINE (07-07-2022). Acute care performance indicators and indicators related to acute general surgery were collected and collated following a care pathway approach. Indicators assessing identical clinical measures were grouped under a common indicator title. The trends from each group of indicators were collated (increase/decrease/stable). Results A total of 152 studies were included. 2354 indicators regarding general acute care and 301 indicators related to acute general surgery were included. Indicators focusing on pre-hospital services reported a decreasing trend in the volume of patients: from 225 indicators, 110 (49%) reported a decrease. An increasing trend in pre-hospital treatment times was reported by most of the indicators (n = 41;70%) and a decreasing trend in survival rates of out-of-hospital cardiac arrest (n = 61;75%). Concerning care provided in the emergency department, most of the indicators (n = 752;71%) showed a decreasing trend in admissions across all levels of urgency. Concerning the mortality rate after admission, most of the indicators (n = 23;53%) reported an increasing trend. The subset of indicators assessing acute general surgery showed a decreasing trend in the volume of patients (n = 50;49%), stability in clinical severity at admission (n = 36;53%), and in the volume of surgeries (n = 14;47%). Most of the indicators (n = 28;65%) reported no change in treatment approach and stable mortality rate (n = 11,69%). Conclusion This review signals relevant disruptions across the acute care pathway. A subset of general surgery performance indicators showed stability in most of the phases of the care pathway. These results highlight the relevance of assessing this care pathway more regularly and systematically across different clinical entities to monitor disruptions and to improve the resilience of emergency services during a crisis.

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Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020-2021): a scoping review

Carvalho

Broekema

Fernandes

et al. 2023

Preprint

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Background: The COVID-19 pandemic severely impacted health systems, leading to care disruptions for non-COVID patients. Performance indicators to continuously monitor acute care, timely reported and internationally accepted, lacked during the COVID-19 pandemic in OECD countries. Methods: Scoping review. Search in Embase and MEDLINE databases. Acute care performance indicators were collected and collated following the care pathway; indicators related to acute general surgery were analyzed separately. Results: A total of 152 studies were included. 2354 indicators regarding general acute care and 301 indicators related to acute general surgery were collected and collated. Indicators focusing on pre-hospital services reported a decreasing trend in the volume of patients: from 225 indicators, 110 (49%) reported a decrease. An increasing trend in pre-hospital treatment times was reported by most of the indicators (n=41;70%) and a decreasing trend in survival rates of out-of-hospital cardiac arrest (n=61;75%). Concerning care provided in the emergency department, most of the indicators (n=752;71%) showed a decreasing trend in admissions, across all levels of urgency (n=26, 51% of highly urgent/level 1 indicators; n=20, 56% of level 2; n=31, 67% of level 3 and 4; and n=43, 78% of non-urgent/level 5 indicators). Indicators assessing the volume of diagnostic and treatment procedures signaled reductions: 65% (n=85) of the indicators and 51% (n=54) of the indicators, respectively. Concerning the mortality rate after admission, most of the indicators (n=23;53%) reported an increasing trend. The subset of indicators assessing acute general surgery showed a decreasing trend in the volume of patients reported by most of the indicators (n=50,49%), stability in clinical severity at admission (n=36,53%), and stability in the volume of surgeries (n=14,47%). Most of the indicators (n=28,65%) reported no change in treatment approach and stable mortality rate (n=11,69%). Conclusions: This review summarizes the performance indicators available in the literature to assess the quality of acute care in OECD countries and their trends during the first year and a half of the COVID-19 pandemic (2020-July2021). These results highlight the relevance of assessing the acute care pathway more regularly and systematically across different clinical entities, to monitor care disruptions and improve the resilience of emergency services to crises.

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The influence of COVID-19 lockdowns on presentation with spontaneous posterior vitreous detachment to the emergency department in Italy

Cited by 3 publications

References 38 publications

Presentations to eye emergency departments with flashes and floaters differ dependent on incident solar radiation

Presentations to eye emergency departments with flashes and floaters differ dependent on incident solar radiation

Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020–2021): a scoping review

Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020-2021): a scoping review

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