Patología quirúrgica emergente durante la pandemia COVID-19 en un hospital de segundo nivel en Ecuador
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Vive Rev. Salud
Abstract
Introducción: Desde la declaración de pandemia por la OMS el once de marzo de 2020, ha existido un descenso en los ingresos de pacientes quirúrgicos por la paralización de la cirugía electiva y la disminución de procedimientos quirúrgicos emergentes. Objetivo: Analizar la incidencia y características de la patología quirúrgica emergente en un hospital de segundo nivel en Ecuador. Material y métodos: Estudio retrospectivo, descriptivo, que incluyó a todos los pacientes sometidos a cirugía general emergente en el Hospital General Riobamba IESS, desde el once de marzo hasta el once de agosto de 2020. Resultados: En el estudio se incluyeron 63 pacientes, con una media de edad de 48,54 años; el 50,8% fueron hombres. El diagnóstico más frecuente fue apendicitis aguda en 61,9% casos. Se realizaron 66 cirugías, 36,5% fueron apendicectomías convencionales. El abordaje abierto se llevó a cabo en 68,2% de los pacientes. El 12,7% de pacientes presentaron COVID-19 en el perioperatorio de los cuales 25% fallecieron. La mortalidad general fue del 7,9% y todos los pacientes fallecidos fueron hombres. Discusión: La evidencia acerca del manejo quirúrgico durante la pandemia COVID-19 aún es limitada. La patología quirúrgica emergente no se puede diferir, se deben tener en cuenta el incremento en la mortalidad de pacientes infectados y el riesgo de exposición del equipo quirúrgico. Conclusión: Durante la pandemia se produjo un descenso en las cirugías realizadas en nuestro centro, la apendicitis aguda continúa siendo la principal patología quirúrgica emergente. La mortalidad se asoció al sexo masculino y diagnóstico de COVID-19.
Introduction: Since the declaration of a pandemic by the WHO on March 11, 2020, there has been a decrease in the admissions of surgical patients due to the paralyzation of elective surgery and the decrease in emerging surgical procedures. Objective: To analyze the incidence and characteristics of emerging surgical pathology in a second level hospital in Ecuador. Material and methods: Retrospective and descriptive study, which included all the patients undergoing emergency general surgery at Hospital General Riobamba IESS, from March 11 to August 11, 2020. Results: 63 patients were included in the study, with a mean age of 48.54 years; 50.8% were men. The most frequent diagnosis was acute appendicitis in 61.9% cases. 66 surgeries were performed, 36.5% were conventional appendicectomies. The open approach was carried out in 68.2% of the patients. 12.7% of patients presented COVID-19 in the perioperative period, of which 25% died. Overall mortality was 7.9% and all deceased patients were men. Discussion: The evidence about surgical management during the COVID-19 pandemic is still limited. Emerging surgical pathology cannot be deferred, the increased mortality of infected patients and the risk of exposure of the surgical team must be taken into account. Conclusion: During the pandemic there was a decrease in the surgeries performed in our center, acute appendicitis continues to be the main emerging surgical pathology. Mortality was associated with male sex and diagnosis of COVID-19.
Introduction: Since the declaration of a pandemic by the WHO on March 11, 2020, there has been a decrease in the admissions of surgical patients due to the paralyzation of elective surgery and the decrease in emerging surgical procedures. Objective: To analyze the incidence and characteristics of emerging surgical pathology in a second level hospital in Ecuador. Material and methods: Retrospective and descriptive study, which included all the patients undergoing emergency general surgery at Hospital General Riobamba IESS, from March 11 to August 11, 2020. Results: 63 patients were included in the study, with a mean age of 48.54 years; 50.8% were men. The most frequent diagnosis was acute appendicitis in 61.9% cases. 66 surgeries were performed, 36.5% were conventional appendicectomies. The open approach was carried out in 68.2% of the patients. 12.7% of patients presented COVID-19 in the perioperative period, of which 25% died. Overall mortality was 7.9% and all deceased patients were men. Discussion: The evidence about surgical management during the COVID-19 pandemic is still limited. Emerging surgical pathology cannot be deferred, the increased mortality of infected patients and the risk of exposure of the surgical team must be taken into account. Conclusion: During the pandemic there was a decrease in the surgeries performed in our center, acute appendicitis continues to be the main emerging surgical pathology. Mortality was associated with male sex and diagnosis of COVID-19.
Description
Vol. 3, No. 9