COVID-19 pandemic: changes in cancer admissions.

hospital care supportive care

Journal

BMJ supportive & palliative care
ISSN: 2045-4368
Titre abrégé: BMJ Support Palliat Care
Pays: England
ID NLM: 101565123

Informations de publication

Date de publication:
14 Jul 2020
Historique:
received: 30 05 2020
revised: 02 07 2020
accepted: 02 07 2020
entrez: 16 7 2020
pubmed: 16 7 2020
medline: 16 7 2020
Statut: aheadofprint

Résumé

COVID-19 pandemic could create a collateral damage to cancer care denoting disruptions in care due to a significant burden on healthcare and resource allocations. Herein, we evaluate the early changes in the inpatient and outpatient oncology clinics to take a snapshot of this collateral damage at Hacettepe University Cancer Institute. Patients applying the outpatient clinic and outpatient palliative care (OPC) clinic for the first time and patients admitted to inpatient wards in the first 30 days after the first case of COVID-19 in Turkey were evaluated. These data were compared with data from the same time frame in the previous 3 years. The mean number of daily new patient applications to the outpatient clinic (9.87±3.87 vs 6.43±4.03, p<0.001) and OPC clinic (3.87±1.49 vs 1.13±1.46, p<0.001) was significantly reduced compared with the previous years. While the number of inpatient admissions was similar for a month frame, the median duration of hospitalisation was significantly reduced. The frequency of hospitalisations for chemotherapy was higher than in previous years (p<0.001). By comparison, the rate of hospitalisations for palliative care (p=0.028) or elective interventional procedures (p=0.001) was significantly reduced. In our experience, almost all domains of care were affected during the pandemic other than patients' systemic treatments. There were significant drops in the numbers of newly diagnosed patients, patients having interventional procedures and palliative care services, and these problems should be the focus points for the risk mitigation efforts for prevention of care disruptions.

Sections du résumé

BACKGROUND BACKGROUND
COVID-19 pandemic could create a collateral damage to cancer care denoting disruptions in care due to a significant burden on healthcare and resource allocations. Herein, we evaluate the early changes in the inpatient and outpatient oncology clinics to take a snapshot of this collateral damage at Hacettepe University Cancer Institute.
METHODS METHODS
Patients applying the outpatient clinic and outpatient palliative care (OPC) clinic for the first time and patients admitted to inpatient wards in the first 30 days after the first case of COVID-19 in Turkey were evaluated. These data were compared with data from the same time frame in the previous 3 years.
RESULTS RESULTS
The mean number of daily new patient applications to the outpatient clinic (9.87±3.87 vs 6.43±4.03, p<0.001) and OPC clinic (3.87±1.49 vs 1.13±1.46, p<0.001) was significantly reduced compared with the previous years. While the number of inpatient admissions was similar for a month frame, the median duration of hospitalisation was significantly reduced. The frequency of hospitalisations for chemotherapy was higher than in previous years (p<0.001). By comparison, the rate of hospitalisations for palliative care (p=0.028) or elective interventional procedures (p=0.001) was significantly reduced.
CONCLUSION CONCLUSIONS
In our experience, almost all domains of care were affected during the pandemic other than patients' systemic treatments. There were significant drops in the numbers of newly diagnosed patients, patients having interventional procedures and palliative care services, and these problems should be the focus points for the risk mitigation efforts for prevention of care disruptions.

Identifiants

pubmed: 32665259
pii: bmjspcare-2020-002468
doi: 10.1136/bmjspcare-2020-002468
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Deniz Can Guven (DC)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey denizcguven@hotmail.com.

Burak Yasin Aktas (BY)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Melek Seren Aksun (MS)

Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Enes Ucgul (E)

Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Taha Koray Sahin (TK)

Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Hasan Cagri Yildirim (HC)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Gurkan Guner (G)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Neyran Kertmen (N)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Omer Dizdar (O)

Department of Preventive Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Saadettin Kilickap (S)

Department of Preventive Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Sercan Aksoy (S)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Suayib Yalcin (S)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Alev Turker (A)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Fatih Mehmet Uckun (FM)

COVID-19 Task Force, Worldwide Clinical Trials, Wayne, Pennsylvania, USA.

Zafer Arik (Z)

Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.

Classifications MeSH