1. Safety of ‘hot’ and ‘cold’ site admissions within a high volume urology department in the United Kingdom at the peak of the COVID-19 pandemic
- Author
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Marios Hadjipavlou, Jane Cossins, Ella Di Benedetto, J. Glass, Jonathon Olsburgh, Anna Walsh, Nick Simson, Pinky Kotecha, Benjamin Challacombe, Bethany Jackson, Arun Sahai, Rajesh Nair, Jonah Rusere, Ramandeep Chalokia, Oussama El Hage, Raveen Sandher, Findlay MacAskill, Harold Omana, Grace Zisengwe, Prokar Dasgupta, Beth Russell, Rick Popert, Anastasia Kantartzi, Thomasia Azavedo, Kathryn Chatterton, Luke Stroman, Louisa Fleure, Elsie Mensah, Tim O'Brien, Matthew Bultitude, Adeoye Oluwakanyinsola Debo-Aina, Meghana Kulkarni, Leslie Cooper, Muhammad Shamim Khan, Jeffrey Ritualo, Amelia Barber, Lily Studd, Yamini Kailash, Paul Cathcart, Katherine Guest, Li June Tay, Sharon Clovis, Majed Shabbir, Vugar Ismaylov, Liza Mills, Luis Felipe Ribeiro, Christian Brown, Sachin Malde, Rhana Zakri, Kay Thomas, Tet Yap, Susan Willis, Cassandra McDonald, Ramesh Thurairaja, Archana Fernando, Francesca Kum, Ella Doerge, Elizabeth Eversden, Claire Taylor, and Catherine Roberts
- Subjects
medicine.medical_specialty ,business.industry ,Interquartile range ,Under-reporting ,Mortality rate ,Pandemic ,Cohort ,Emergency medicine ,Medicine ,Retrospective cohort study ,Elective surgery ,business ,Logistic regression - Abstract
BackgroundContracting COVID-19 peri-operatively has been associated with a mortality rate as high as 23%, making prevention vital.ObjectivesThe primary objective is to determine safety of surgical admissions and procedures during the height of the COVID-19 pandemic using ‘hot’ and ‘cold’ sites. The secondary objective is to determine risk factors of contracting COVID-19.Design, Setting and ParticipantsA retrospective cohort study of all consecutive patients admitted from 1st March – 31st May 2020 at a high-volume tertiary urology department in London, United Kingdom. Elective surgery was carried out at a ‘cold’ site requiring a negative COVID-19 swab 72 hours prior to admission and to self-isolate for 14 days pre-operatively, whilst all acute admissions were admitted to the ‘hot’ site.Outcome Measurements and Statistical AnalysisComplications related to COVID-19 were presented as percentages. Risk factors for developing COVID-19 infection were determined using multivariate logistic regression analysis.Results and LimitationsA total of 611 patients, 451 (73.8%) male and 160 (26.2%) female, with a median age of 57 (interquartile range 44-70) were admitted under the urology team; 101 (16.5%) on the ‘cold’ site and 510 (83.5%) on the ‘hot’ site. Procedures were performed in 495 patients of which 8 (1.6%) contracted COVID-19 post-operatively with 1 (0.2%) post-operative mortality due to COVID-19. Overall, COVID-19 was detected in 20 (3.3%) patients with 2 (0.3%) deaths. Length of stay was associated with contracting COVID-19 in our cohort (OR 1.25, 95% CI 1.13-1.39). Limitations include possible under reporting due to post-operative patients presenting elsewhere.ConclusionsContinuation of surgical procedures using ‘hot’ and ‘cold’ sites throughout the COVID-19 pandemic was safe practice, although the risk of COVID-19 remained and is underlined by a post-operative mortality.Patient SummaryUsing ‘hot’ and ‘cold’ sites has allowed the safe continuation of urological practice throughout the height of the COVID-19 pandemic.
- Published
- 2020
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