scholarly journals P036 IMPACT OF THE COVID-19 PANDEMIC ON HERNIA SURGERY IN A SWEDISH HEALTH-CARE REGION WITHOUT LOCKDOWN: A RETROSPECTIVE COHORT STUDY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Christos Kollatos ◽  
Ali Alhussain ◽  
Sarmad Hanna

Abstract Aim During the COVID-19 pandemic, Swedish health care centers were restructured. This was accompanied by changes in the surgical programme. The aim of this study was to determine the effects of COVID-19 on emergency and elective hernia surgeries in a Swedish health-care region. Material and Methods This was a retrospective, observational cohort study. Data from inguinal and ventral hernia surgeries were retrieved from a medical database using procedure codes from all three hospitals in Region Jönköping County from March 1, 2019 to January 31, 2021. The participants were divided into two groups: COVID-19 group (March 1, 2020 - January 31, 2021) and reference group (March 1, 2019 - January 31, 2020). The incidence rate (IR) and relative risk (RR) of operations over different time frames were analyzed. Results A total 1351 participants met the inclusion criteria. 590 were operated during the COVID-19 period and 761 during the reference period. The IR of elective operations was decreased during the COVID-19 pandemic; 146 operations/100.000 population vs 192 operations/100.000 population during the reference period. RR was 0,76 (95% CI 0.6813-0.8545, p < 0.0001). Moreover, IR of emergency operations decreased insignificantly during the COVID-19 pandemic; 17,5 operations/100.000 population vs 19,4 operations/100.000 population during the reference period. RR was 0,9 (95% CI 0.6404- 1.2649, p 0.5441). No significant variations in the emergency operations have identified when different time frames were compared. Conclusions There is no evidence to support that COVID-19 pandemic has increased emergency hernia operations during the studied period despite the significant reduction of elective operations.

Author(s):  
Helena Reimertz ◽  
Fredrik Spak ◽  
Hanne Tønnesen

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 46
Author(s):  
Tina Hansen ◽  
Rikke Lundsgaard Nielsen ◽  
Morten Baltzer Houlind ◽  
Juliette Tavenier ◽  
Line Jee Hartmann Rasmussen ◽  
...  

There is evolving evidence for an association between dysphagia and sarcopenia in older adults. For optimizing the acute health care initiative across health care settings, this study investigated prevalence and time-course of dysphagia in older patients admitted to an emergency department (ED) as well as its association with parameters for probable sarcopenia, inactivity, malnutrition, disease status, and systemic inflammation. A secondary analysis of data from the FAM-CPH cohort study on acutely admitted older medical patients (n = 125). Data were collected upon ED admission as well as four and 56 weeks after discharge. Using the Eating Assessment Tool cut-off score ≥ 2, signs of dysphagia were present in 34% of the patients at ED admission and persisted in 25% of the patients 56 weeks after discharge. Signs of dysphagia at 56-week follow-up were significantly (p < 0.05) associated with probable sarcopenia (low handgrip strength (OR = 3.79), low leg muscle strength (OR = 8.14), and low physical performance (OR = 5.68)) and with baseline swallowing inactivity (OR = 5.61), malnutrition (OR = 4.35), and systemic inflammation (OR = 1.33). Signs of dysphagia in older patients admitted to an ED was prevalent, persisted 56 weeks after discharge, and was associated with probable sarcopenia and related conditions; all modifiable targets for management of dysphagia in older patients.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
BV Silva ◽  
T Rodrigues ◽  
N Cunha ◽  
J Brito ◽  
P Alves Da Silva ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background During the COVID-19 pandemic many countries have imposed lockdown restrictions to movement. Since the 18th of March in Portugal, thousands of people have been confined to their homes. While hospital admissions for COVID-19 patients increased exponentially, admissions for non-COVID-19 patients decreased dramatically. However, it remains unclear whether lockdown-related immobility can contribute to the increased incidence of pulmonary embolism. Purpose To compare the incidence of pulmonary embolism (PE) during the lockdown period (Abril 1 to May 31, 2020) compared to the reference period in 2019. Methods Retrospective study of consecutive outpatients who presented to the emergency department and underwent computed tomography pulmonary angiography (CTPA) due to suspicion of PE. Results Compared to the same period of 2019, the lockdown period was associated with a significant increase in PE diagnosis (29 versus 18 patients). PE patients during lockdown were older (median age 71 years; interquartile range [IQR][60-85] versus 59 years [44-76]; p = 0.046) and have lower prevalence of active cancer (14% versus 33% in the reference period). Women represent 55% (n = 16) of patients in lockdown group (versus 50% in 2019 group). Clinical probability (GENEVA score) was similar in both groups (median score 2.72 in lockdown group and 2.50 in reference group, p = 0.452). None of the patients with PE was diagnosed with COVID-19. Conclusion We have observed a marked increase (62%) in PE diagnosis during lockdown period compared to the reference period, which can be explained by the reduction in physical activity due to teleworking and closure of gyms and sports activities. These data reinforce the importance of promoting physical activity programs at home. The role of pharmacological or mechanical thromboprophylaxis in this scenario remains unclear.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.


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