The impact of early information concerning the surgical operations on anxiety in patients with burns

Burns ◽  
2020 ◽  
Author(s):  
Gera A. Hartlief ◽  
Anuschka S. Niemeijer ◽  
Kirsten F. Lamberts ◽  
Marianne K. Nieuwenhuis
Keyword(s):  
Early Information ◽  
The Impact ◽  
Surgical Operations

scholarly journals Long Term Implications in Surgical Re-assisting (L.I.S.A. study) During Covid-19 Outbreak: A Retrospective Observational Study on a Rural Population.

2021 ◽  
Author(s):  
Nicolò Fabbri ◽  
Antonio Pesce ◽  
Lisa Uccellatori ◽  
Salvatore Greco ◽  
Francesco D'Urbano ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Operative Management ◽  
Surgical Interventions ◽  
Male Sex ◽  
Non Operative Management ◽  
The Impact ◽  
Colorectal Resections ◽  
Surgical Operations ◽  
Over Time

Abstract BackgroundThe spread of the COVID-19 is having a worldwide impact on surgicaltreatment. Our aim was to investigate the impact of the pandemic in a rural hospital in a lowdensely populated area.MethodsWe investigated the volume and type of surgical operations during the pandemic(March 2020 - February 2021) versus pre-pandemic period (March 2019 - February 2020) aswell as during the first and second pandemic waves compared to the pre-pandemic period.We compared the volume and timing of emergency appendectomy and cholecystectomyduring the pandemic versus pre-pandemic period, the volume, timing and stages of electivegastric and colorectal resections for cancer during the pandemic versus the pre-pandemicperiod.ResultsIn the prepandemic versus pandemic period, 42 versus 24 appendectomies and 174versus 126 cholecystectomies (urgent and elective) were performed. Patients operated onbefore as opposed to during the pandemic were older (58 vs. 52 years old, p=0.006),including for cholecystectomy (73 vs. 66 years old, p=0.01) and appendectomy (43 vs. 30years old, p = 0.04).The logistic regression analysis with regard to cholecystectomy and appendectomy performedin emergency showed that male sex and age were both associated to gangrenous typehistology, both in pandemic and prepandemic period. Finally, we found a reduction in cancerstage I and IIA in pandemic versus prepandemic period, with no increase in the moreadvanced stages.Conclusionsthe reduction in services imposed by governments during the first months oftotal lock down did not justify the whole decrease in surgical interventions in the year of thepandemic. Data suggest that greater "non-operative management" for cases of appendicitisand acute cholecystitis does not lead to an increase in cases operated over time, nor to anincrease in the "gangrenous" pattern, which seems to depend on age advanced and malepopulation.

scholarly journals Impact of the Health Transformation Plan on the Number of Surgical Operations and Their Cancelation

2019 ◽  
Vol 56 ◽  
pp. 004695801984638
Author(s):  
MahmoodReza Miri Bonjar ◽  
Mohammad Khammarnia ◽  
Mahdie Bakhshi ◽  
Alireza Ansari-Moghaddam ◽  
Hassan Okati–Aliabad ◽  
...  
Keyword(s):  
Health Insurance ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Outpatient Service ◽  
Public Hospitals ◽  
Inpatient Service ◽  
Treatment Needs ◽  
Study Population ◽  
The Impact ◽  
Surgical Operations

Operation cancelations are a serious problem with undesirable consequences. The Health Transformation Plan was launched in the health system of Iran on May 5, 2014, to enhance the efficiency and quality of services in public hospitals. Comprehensive coverage of patients’ basic treatment needs and reduction of patients’ out-of-pocket expenditures through insurance for all are other objectives of Health Transformation Plan as well. Then, the present study aimed to determine the impact of the Health Transformation Plan on the number of surgical operations and the cancelation of elective surgeries within public hospitals of Iran. This retrospective comparative study was conducted in 2017 within 2 tertiary public hospitals in the South-East of Iran. Using systematic random sampling method and census, 8138 scheduled surgical files and all canceled operations files were reviewed from April 2012 to March 2017, respectively. A standard checklist was used for data collection. The data were analyzed using χ2 test and a logistic regression model in SPSS, version 21. The study population was 8138 patients with mean age of 33 ± 19 years. Female patients comprised about 51% of the study population (n = 4115), and nearly two-third of them were married (n = 5192 [63.79%]). Coverage by Iranian health insurance was reported in more than half of patients (n = 4415 [54.79%]). The common reason for surgeries was injury and poisoning (n = 2814 [34.52%]) followed by delivery (n = 1747 [21.46%]). The number of operations increased from 26 677 before Health Transformation Plan (cancelation rate = 1.5%) to 33 190 after Health Transformation Plan (cancelation rate = 2.0%). The cancelation rate had a significant relationship with age (odds ratio = 1.009; confidence interval: 1.00-1.01), health insurance status (odds ratio = 2.12; confidence interval: 1.33-3.38), outpatient service referrals (odds ratio = 0.5; confidence interval: 0.43-0.62), inpatient service referrals (odds ratio = 1.5; confidence interval: 1.36-1.77), and surgical types ( P < .05). In general, the Health Transformation Plan was markedly associated with a rise in the number of surgeries and cancelation rate in the public hospitals. The information obtained in the present study concerning the causes of operation cancelations can be used to decrease the number of future cancelations.

P0308IMPACT OF MAJOR SURGICAL OPERATIONS ON CLINICAL OUTCOME IN DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rezzan Eren Sadioğlu ◽  
Gizem Kumru Şahin ◽  
Sim Kutlay ◽  
Şule Şengül ◽  
Kenan Keven ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Cox Regression ◽  
Perioperative Complications ◽  
Cerebrovascular Event ◽  
Surgical Operation ◽  
Dialysis Patients ◽  
Coronary Syndrome ◽  
Inflammatory Status ◽  
The Impact ◽  
Surgical Operations

Abstract Background and Aims We aimed to study the impact of major surgical operations on clinical outcome in patients with end-stage kidney disease treated with haemodialysis (HD) or peritoneal dialysis (PD). Method We retrospectively evaluated the records of all patients on HD and PD, who had been treated for at least 3 months at our outpatient clinics between January 1, 2014 and December 31, 2018. In addition to clinical and laboratory parameters, data on all major surgical operations were recorded. Results Among the 202 patients, 133 (66%) were on HD and 69 (34%) on PD. The mean age (±SD) was 58.3±14.5 years, 48% were female and 28% had diabetes mellitus. Forty-seven patients (23%) had a major surgical operation. The operation types were cardiovascular in 14 patients, orthopaedic in 11, gastrointestinal in 8, genitourinary in 6, parathyroidectomy in 5 and brain, pulmonary and breast in 1 patient each. Operations were emergent in 10 patients (21%) and elective in the others (79%). Among the whole study population, 59 patients (29%) died during the study period. In Kaplan-Meier analysis (Figure), mean (95% CI) survival time in operated patients was 43 months (37 to 49 months), while it was 49 months (46 to 52 months) in the others (p=0.023). Fifteen out of 23 deaths (65%) among the operated patients occurred in the first month after surgery. Severe perioperative complications (arrhythmias, hypervolemia, hypotension, bleeding, acute coronary syndrome, respiratory failure and cerebrovascular event) were recorded in 17 (36%) of the operated patients, of whom 16 died (p=0.001). Although did not reach a significant level, mortality rate tended to be higher after emergent operations than that after elective operations. Cox regression analyses revealed that age (RR 1.033, 95% CI 1.010-1.057, p=0.005), diabetes (RR 2.581, 95% CI 1.474-4.521, p=0.001), preoperative C-reactive protein level (RR 1.005, 95% CI 1.002-1.007, p&lt;0.0001) and having a major surgical operation (RR 1.868, 95% CI 1.068-3.268, p=0.028) were the independent predictors of mortality. Conclusion Although prospective studies with a higher patient number are needed to confirm, our study shows that, in addition to age, diabetes and inflammatory status, having a major surgical operation is an independent risk factor for mortality in dialysis patients. The prevention and management of perioperative complications properly may result in more favourable outcomes in these patients.

scholarly journals The impact of COVID-19 on the surgical operations

2020 ◽  
Vol 57 ◽  
pp. 49-51
Author(s):  
Tagleb S. Mazahreh ◽  
Abdelwahab J. Aleshawi ◽  
Nabil A. Al-Zoubi ◽  
Moad Hatamleh ◽  
Alaa Hmedat
Keyword(s):  
The Impact ◽  
Surgical Operations

scholarly journals P-O08 Effect of socioeconomic deprivation on clinical characteristics and outcomes of patients undergoing an emergency appendectomy

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Gillian Miller ◽  
Khurram Khan ◽  
Lewis Gall ◽  
Y AlAzzawi ◽  
Andrew Macdonald
Keyword(s):  
Surgical Site Infection ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
Electronic Records ◽  
Site Infection ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Index Of Multiple Deprivation ◽  
Peak Blood ◽  
Surgical Operations

Abstract Background Appendicectomy is one of the commonest emergency general surgical operations performed.  Previous studies have shown that socioeconomic status (SES) impact outcomes in a number of diseases.  Currently, there is no study analysing the impact of SES on the outcome of appendectomy.   Our aim was to compare the clinical characteristics and outcomes of adults having an emergency appendectomy between deprived and less deprived SES groups.   Methods A multicentre retrospective observational study of all adult patients who had an emergency appendectomy across four hospitals (two district general and two tertiary care hospitals) between August 2018 and November 2020 was performed.  Patients were identified through pathology records.  Data was extracted from electronic records for demographics, pre-operative (peak) blood results, pre and post-operative imaging, operative details and the clinical outcomes.  Patient’s residential address was used to calculate Scottish Index of Multiple Deprivation (SIMD).  The patients were grouped by SIMD into a more deprived SES group (SIMD 1-5) and a less deprived SES group (SIMD 6-10) and results compared. Results A total of 1,105 patients (57.5% male) were included.  Median age was lower in the more deprived group (35 vs 40 years, p &lt; 0.001).   The less deprived group were more likely to be fitter: ASA-1 grade 51.6% vs 43.5%, p = 0.008.  There were fewer appendectomies in most deprived decile compared to the least deprived decile (5.2 vs 11.3 per 10,000 population per year, p &lt; 0.001).   There was no difference in inflammatory markers, pre-operative imaging, surgical approach, severity of appendicitis and the median length of stay (3 days).  However, there were more surgical site infection in the more deprived group (3.4% vs 0.9%, p = 0.006). Conclusions This study demonstrates that SES does impact on the age of presentation and incidence of appendectomy.  Surgical site infection were seen more frequently in the more deprived patients undergoing emergency appendectomy.  This may be a reflection of the underlying comorbidities.

scholarly journals The impact of the COVID-19 pandemic on pediatric operations: a retrospective study of Chinese children

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Yi Wei ◽  
Chengjun Yu ◽  
Tian Xin Zhao ◽  
Tao Lin ◽  
H. E. Dawei ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Present Situation ◽  
Protective Equipment ◽  
Rna Detection ◽  
Healthcare Facilities ◽  
Number Of Patients ◽  
High Level ◽  
Medical University ◽  
The Impact ◽  
Surgical Operations

Abstract Background The aim of this study was to quantify the impact of coronavirus disease 2019 (COVID-19) on pediatric operations, and establish preoperative, intraoperative, and postoperative protocols to improve the pediatric operations. Methods We here compare the number of patients who underwent surgery in Chongqing Medical University Affiliated Children’s Hospital during the pandemic (January 23–March 11), after the pandemic (March 12–April 30), after our measures were put in place (May 1–May 21), and the equivalent period in 2019. Result During the COVID-19 pandemic, 62.68% fewer patients underwent surgery than during the homologous period of time 1 year earlier (P < 0.01). After the COVID-19 pandemic, the number of orchidopexy cases increased significantly from 175.14 to 504.57 per week (P < 0.01). The large number of patients that accrued in our hospital may have increased the risk of COVID-19 transmission. In response, hospitals and clinics have made protocols and reorganized healthcare facilities (e.g., performing nucleic acid tests (NAT), adding adequate personal protective equipment (PPE)) from May 1, 2020. After the measures were implemented, the number of operations performed remained stable and comparable to the pre-pandemic period. COVID-19 RNA detection was performed in 5104 cases and there were no new confirmed cases in our hospital. Conclusion This outbreak of COVID-19 has affected not only individuals with COVID-19 but also patients seeking surgical operations. Understanding the present situation helps clinicians provide a high level of treatment to all children.

scholarly journals A Comparative Study of the Impact of Coronavirus (COVID -19) on the Therapeutic Practices of Cancer Patients in the Kingdom of Saudi Arabia and Egypt

2021 ◽  
pp. 28-39
Author(s):  
Madiha Rabie Mahmoud ◽  
Dalal Saad Hedmool Alshammari ◽  
Maryam Abdullah Alshammari ◽  
Aala Hazza Alhobera ◽  
Osama Gad Abdelaziz ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Cancer Patients ◽  
Kingdom Of Saudi Arabia ◽  
Good Opportunity ◽  
Adequate Care ◽  
Serious Infections ◽  
Drug Doses ◽  
Hospital Practices ◽  
The Impact ◽  
Surgical Operations

Cancer patients are considered one of the most vulnerable to infection with Corona virus (COVID-19), especially who are elderly, multiple comorbidities, and are often immunosuppressed by their cancer or therapy. The immune system of cancer patients is very weak compared to the healthy individuals, so, morbidity and mortality of any serious infections expected to be high among them. This research aims to study the impact of COVID-19 pandemic on cancer patients practices in Saudi Arabia (KSA) and compare with the result in Egypt. It was conducted through a well-structured questionnaire, among cancer patients either online (KSA) or paper questionnaire (Egypt). The questionnaire consists of 16 questions about Scio-demographic and changes in time and method of treatment (chemotherapy and radiotherapy), postponed of surgical operations. Our results showed significant differences between KSA and Egypt hospital practices; cancer department was affected by postponed appointment (54.8% & 63.3%), diagnosis (32.7% & 60%) and treatment of cancer patients (37.1% & 63.3%) respectively. Also, postponed of chemotherapy/radiotherapy (56.8% & 73.3%), surgical operations (45% & 43.3%), an increase in the deterioration of cancer by (35.5% & 23.3%), switching from parenteral injection to oral (27.8% & 56.7%) and changing in the drug doses (19.5% & 40%) in KSA and Egypt respectively. We can conclude that management of cancer patients during COVID-19 pandemic of great importance and so, switching from parenteral to oral, prolongation of the treatment period and postponed of some surgical operations gave a good opportunity to maintain adequate care of cancer patient with minimum exposure of patients to infection.

scholarly journals Early Laparoscopic Cholecystectomy Service Provision is Feasible and Safe in the Current UK National Health Service

2009 ◽  
Vol 91 (8) ◽  
pp. 660-664 ◽  
Author(s):  
S Agrawal ◽  
N Battula ◽  
L Barraclough ◽  
D Durkin ◽  
CVN Cheruvu
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Care ◽  
Early Laparoscopic Cholecystectomy ◽  
Emergency Procedures ◽  
Surgical Trainees ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Theatre List ◽  
Surgical Operations

INTRODUCTION Despite increasing evidence of the benefits and safety of early laparoscopic cholecystectomy (LC) in acute gallstone disease, it is not widely practised in England. The Royal College of Surgeons of England support the separation of emergency and elective surgical care. The aim of this prospective study was to examine the impact of the implementation of ‘Surgeon of the Week (SoW)’ model on the number of early LCs performed and the efficiency of the emergency theatre activity in our hospital. This study also looked into its implications on specialist registrar training for early LC, and the financial impact to the hospital. PATIENTS AND METHODS Between January 2007 and May 2008, demographic data, admission and discharge dates, complications, conversions to an open operation and deaths were collected for all patients who underwent early laparoscopic cholecystectomies. For ease of comparison, patients were divided into Group A representing before introduction of SoW (1 January 2007 to 30 August 2007) and Group B representing after introduction of SoW (1 October 2007 to 31 May 2008). The total numbers of operations performed in the emergency theatre list in the two groups were also calculated. RESULTS A total of 1361 emergency operations were performed on the emergency theatre list in Group A, of which 951 were general surgical procedures. In Group B, the numbers of emergency procedures were 1537, of which 1138 were general surgical operations. There was a significant increase in the number of general surgical operations after introduction of SoW (P = 0.013). Before introduction of the SoW rota, 45 early LCs were performed. This increased to 118 after SoW which was significant (P < 0.001). In Group A, the number of early LCs performed by surgical trainees was 10 (22%). In Group B, the number of LCs performed by surgical trainees was 35 (30%; not significant). CONCLUSIONS This study has demonstrated an increase in the efficiency of the emergency theatre with an increase in the number of early LCs on their index admission without extra morbidity following implementation of the SOW model in our hospital. We recommend the introduction of a suitable emergency surgical consultant on-call model separating emergency and elective surgical care depending on local circumstances. This can lead to significant cost savings and reduce re-admissions with gallstone-related complications.

Formation of Lunar Craters and Bright Rays as a Result of Meteorite Impacts

1962 ◽  
Vol 14 ◽  
pp. 415-418
Author(s):  
K. P. Stanyukovich ◽  
V. A. Bronshten
Keyword(s):  
Explosive Charge ◽  
The Moon ◽  
Meteorite Impacts ◽  
The Earth ◽  
Lunar Craters ◽  
The Impact

The phenomena accompanying the impact of large meteorites on the surface of the Moon or of the Earth can be examined on the basis of the theory of explosive phenomena if we assume that, instead of an exploding meteorite moving inside the rock, we have an explosive charge (equivalent in energy), situated at a certain distance under the surface.

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