Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic.
COVID-19
/ epidemiology
Cross-Sectional Studies
Global Health
/ statistics & numerical data
Humans
Infection Control
/ methods
Medical Oncology
/ methods
Needs Assessment
Organizational Innovation
Practice Patterns, Physicians'
/ organization & administration
SARS-CoV-2
Time-to-Treatment
/ statistics & numerical data
Triage
/ organization & administration
Urologic Neoplasms
/ epidemiology
Urologic Surgical Procedures
/ methods
Coronavirus
Healthcare
SARS-CoV-2
Triage
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
13
05
2020
accepted:
23
06
2020
pubmed:
6
7
2020
medline:
8
2
2022
entrez:
6
7
2020
Statut:
ppublish
Résumé
While the coronavirus disease 2019 (COVID-19) pandemic captures healthcare resources worldwide, data on the impact of prioritization strategies in urology during pandemic are absent. We aimed to quantitatively assess the global change in surgical and oncological clinical practice in the early COVID-19 pandemic. In this cross-sectional observational study, we designed a 12-item online survey on the global effects of the COVID-19 pandemic on clinical practice in urology. Demographic survey data, change of clinical practice, current performance of procedures, and current commencement of treatment for 5 conditions in medical urological oncology were evaluated. 235 urologists from 44 countries responded. Out of them, 93% indicated a change of clinical practice due to COVID-19. In a 4-tiered surgery down-escalation scheme, 44% reported to make first cancellations, 23% secondary cancellations, 20% last cancellations and 13% emergency cases only. Oncological surgeries had low cancellation rates (%): transurethral resection of bladder tumor (27%), radical cystectomy (21-24%), nephroureterectomy (21%), radical nephrectomy (18%), and radical orchiectomy (8%). (Neo)adjuvant/palliative treatment is currently not started by more than half of the urologists. COVID-19 high-risk-countries had higher total cancellation rates for non-oncological procedures (78% vs. 68%, p = 0.01) and were performing oncological treatment for metastatic diseases at a lower rate (35% vs. 48%, p = 0.02). The COVID-19 pandemic has affected clinical practice of 93% of urologists worldwide. The impact of implementing surgical prioritization protocols with moderate cancellation rates for oncological surgeries and delay or reduction in (neo)adjuvant/palliative treatment will have to be evaluated after the pandemic.
Identifiants
pubmed: 32623500
doi: 10.1007/s00345-020-03333-6
pii: 10.1007/s00345-020-03333-6
pmc: PMC7335229
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
3139-3145Informations de copyright
© 2020. The Author(s).
Références
Urology. 2016 Apr;90:e1-2
pubmed: 26772645
Lancet Oncol. 2020 May;21(5):628
pubmed: 32213339
N Engl J Med. 2019 Jul 11;381(2):121-131
pubmed: 31157964
N Engl J Med. 2018 Aug 02;379(5):417-427
pubmed: 29860937
World J Urol. 2014 Apr;32(2):475-9
pubmed: 23455886
Eur Urol Oncol. 2019 Jul;2(4):390-396
pubmed: 31277775
J Med Internet Res. 2004 Sep 29;6(3):e34
pubmed: 15471760
Br J Surg. 2020 Oct;107(11):1440-1449
pubmed: 32395848
N Engl J Med. 2015 Aug 20;373(8):737-46
pubmed: 26244877
Lancet. 2020 Mar 28;395(10229):1047-1053
pubmed: 32199075
Eur Urol. 2020 Jul;78(1):124-126
pubmed: 32349934
N Engl J Med. 2020 May 14;382(20):1873-1875
pubmed: 32187459
Eur Urol. 2020 Jun;77(6):663-666
pubmed: 32279903
Eur Urol. 2020 Jun;77(6):667-668
pubmed: 32312544
Lancet. 2007 Oct 20;370(9596):1453-7
pubmed: 18064739
Lancet Oncol. 2020 May;21(5):619-621
pubmed: 32220659
Nat Rev Urol. 2020 May;17(5):251-253
pubmed: 32203310
Lancet Glob Health. 2020 Apr;8(4):e452-e453
pubmed: 32199105
Eur Urol Focus. 2021 May;7(3):659-661
pubmed: 32405544
Eur Urol. 2020 Aug;78(2):131-133
pubmed: 32303384
J Urol. 2006 Apr;175(4):1262-7; discussion 1267
pubmed: 16515975
N Engl J Med. 2020 Apr 30;382(18):1681-1683
pubmed: 32163699
World J Urol. 2021 Sep;39(9):3127-3138
pubmed: 32462305
Curr Opin Urol. 2013 Sep;23(5):423-8
pubmed: 23880740
J Urol. 2020 Jul;204(1):11-13
pubmed: 32249715
Eur Urol. 2020 Jul;78(1):4-5
pubmed: 32349933
BMC Public Health. 2012 Mar 26;12:241
pubmed: 22449119
JAMA Oncol. 2016 Mar;2(3):330-9
pubmed: 26659430