Utjecaj pandemije COVID-19 na čekanje kardiokirurških zahvata

master's thesis

• Title (english): The impact of the COVID-19 pandemic on the waiting list for cardiac surgery
• Author: Matea Oroz
• Mentor: Tomislav Letilović (mentor)
• Committee member: Hrvoje Gašparović (predsjednik povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Committee member: Tomislav Letilović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Pandemija COVID-19 (Coronavirus Disease 2019) proglašena je od strane Svjetske Zdravstvene Organizacije u ožujku 2020. godine zbog nekontroliranog širenja zaraze SARS-CoV-2 virusom. Pandemija je uzrokovala brojne promjene u svim aspektima svakodnevnog života pa tako i u zdravstvenom sustavu. Radi smanjenja širenja infekcije, u zdravstvene ustanove se primaju samo hitni slučajevi, a svi ostali kojima nije potrebna trenutna pomoć se odgađaju. Navedeno se odnosi na dijagnostičke i terapijske postupke, a zahvaćeni su i kirurški odjeli na kojima se odgađaju operativni zahvati i povećavaju se liste čekanja. U ovom retrospektivnom istraživanju ispitivali smo postoji li razlika u vremenu čekanja pacijenata na kardiokirurške zahvate tijekom i prije pandemije COVID-19. Ukupno je skupljeno podataka za 101 pacijenta te su oni podijeljeni u dvije skupine. Isključeni su pacijenti koji su odustali od operativnog zahvata, koji su operirani u drugim ustanovama, a ne u KBC Zagreb, pacijenti koji nisu odgovorili na poziv, pacijenti koji su preminuli prije operacije i pacijenti za koje nisu skupljeni svi potrebni podaci. U kontrolnoj skupini su pacijenti koji su bili na koronarografiji u KB Merkur u 2019.godini nakon čega su predbilježeni za kardiokirurški operativni zahvat, a u istraživanoj skupini su pacijenti koji su bili na koronarografiji tijekom pandemije u 2020.godini i također predbilježeni za zahvat. Dobiveno je da je medijan čekanja za pacijente u 2019.godini bio 191 dan, a za pacijente u 2020.godini 349 dana. Statističkim testom dobivena je P vrijednost 0.0052 koja ukazuje da je razlika u vremenu čekanja između dviju skupina statistički značajna. Pacijenti dviju skupina su uspoređeni po postojanju, odnosno nepostojanju komorbiditeta – hipertenzije, šećerne bolesti, hiperlipidemije, astme i KOPB-a te po dobi i spolu, ali nisu dobivene statistički značajne razlike u navedenim kriterijima između dviju skupina. Analizirani su i tipovi zahvata pri čemu je utvrđena statistički značajna razlika između broja zahvata na zaliscima u odnosu na provedene zahvate CABG i kombinaciju tih dvaju zahvata ( P=0.02).

Abstract (english)

The World Health Organisation declared COVID-19 (Coronavirus Disease 2019) a pandemic in March, 2020 due to the uncontrolled spread of the SARS-CoV-2 infection. The pandemic has caused significant changes in people's everyday lives and the healthcare system has been affected as well. Hospitals changed priorities and only emergency procedures were performed, while others were postponed. Waiting lists were prolonged for diagnostic and therapeutic methods and surgeries. In this retrospective research we wanted to see if there is any difference between waiting time for cardiac surgery before and during pandemic. We managed to collect data on 101 patients and they were divided into two groups. The patients who declined the surgery, those who underwent surgery in other institutes than University Hospital Center Zagreb, those who died in the meantime, patients who didn't respond to phone call and patients who didn't answer all of the questions were excluded from this research. The control group are the patients who underwent coronarography in University Hospital Merkur and afterwards were predetermined for surgery in 2019 and the other group are the patients who underwent coronarography in 2020. The results showed that the median waiting time for control group was 191 days and for the patients during pandemic 349 days. The statistical analysis showed that the P value was 0.0052 which means that the difference between waiting time for these two groups is statistically significant. The patients were then compared by age, sex and comorbidities - hypertension, diabetes mellitus, hyperlipidaemia, asthma and COPD but there weren't any statistically significant differences observed. Different types of procedures were also analysed. There was significant difference between the valvular procedures and the other two types, CABG and the combination of these two (P value was 0.02).

• Keywords: pandemija; COVID-19; kardiokirurški zahvati; vrijeme čekanja
• Keywords (english): pandemic; COVID-19; cardiac surgery; waiting lists
• Language: croatian
• URN:NBN: urn:nbn:hr:105:656666
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-24 11:45:12