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Cardiac surgery practice during the COVID-19 outbreak: a regionwide survey

Authors
  • De Santo, Luca Salvatore1
  • Rubino, Antonino Salvatore1
  • Torella, Michele1
  • Galbiati, Denise1
  • Iannelli, Gabriele2
  • Iesu, Severino2
  • Tritto, Francesco Paolo2
  • Fiorani, Brenno2
  • Chiariello, Luigi3
  • De Bellis, Antonio2
  • Di Benedetto, Giuseppe2
  • Zebele, Carlo
  • De Feo, Marisa1
  • 1 Vincenzo Monaldi Hospital, Naples , (Italy)
  • 2 ; , (Italy)
  • 3 Clinica Mediterranea, Naples , (Italy)
Type
Published Article
Journal
Journal of Thoracic Disease
Publisher
AME Publishing Company
Publication Date
Jan 01, 2021
Volume
13
Issue
1
Pages
125–132
Identifiers
DOI: 10.21037/jtd-20-2298
PMID: 33569192
PMCID: PMC7867799
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Background Health systems worldwide have been overburdened by the “COVID-19 surge”. Consequently, strategies to remodulate non-COVID medical and surgical care had to be developed. Knowledge of the impact of COVID surge on cardiac surgery practice is mainstem. Present study aims to evaluate the regional practice pattern during lockdown in Campania. Methods A multicenter regional observational 26-question survey was conducted, including all adult cardiac surgery units in Campania, Italy, to assess how surgical practice has changed during COVID-19 national lockdown. Results All centers adopted specific protocols for screening patients and personnel. A significant reduction in the number of dedicated intensive care unit (ICU) beds (–30.0%±38.1%, range: 0–100%) and cardiac operating rooms (–22.2%±26.4%, range: 0–50%) along with personnel relocation to other departments was disclosed (anesthesiologists –5.8%±11.1%, range: 0–33.3%; perfusionists –5.6%±16.7%, range: 0–50%; nurses –4.8%±13.2%, range: 0–40%; cardiologists –3.2%±9.5%, range: 0–28.6%). Cardiac surgeons were never reallocated to other services. Globally, we witnessed dramatically lower adult cardiac surgery case volumes (335 vs. 667 procedures, P<0.001), as institutions and surgeons followed guidelines to curtail non-urgent operations. Conclusions This regional survey demonstrates major changes in practice as a response to the COVID-19 pandemic. In this respect, this experience might lead to the development of permanent systems-based plans for future pandemic and may effectively help policy decision making when prioritizing healthcare resource reallocation during and after the pandemic.

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