Araştırma Makalesi
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Sosyal izolasyon, genel cerrahi hastalarında ikincil hasara neden olur mu?

Yıl 2020, Cilt: 4 Sayı: 7, 523 - 526, 01.07.2020
https://doi.org/10.28982/josam.773722

Öz

Amaç: Pandemi dönemlerinde uygulanan sosyal izolasyonun bazı hasta gruplarında ikincil hasara neden olduğunu gösteren yayınlar mevcuttur. İkincil hasar gelişebileceği korkusu ile hastalar ve hekimler tarafından sosyal izolasyon kurallarına aykırı tavırlar gösterilebilmektedir. Çalışmadaki amacımız; COVID-19 pandemisi sırasında Türkiye’de uygulanan sosyal izolasyonun, genel cerrahi hastalarında meydana getirdiği ikincil hasarları değerlendirmekti.
Yöntemler: Başkent Üniversitesi Ankara ve Konya Uygulama ve Araştırma Merkezleri erişkin acil servisinden genel cerrahi bölümüne konsülte edilen 279 hasta retrospektif olarak incelendi. Hastalar başvuru dönemine göre iki grupa ayrıldı (Grup 1: 01 Mart - 01 Mayıs 2019; n=163, Grup 2: 01 Mart - 01 Mayıs 2020; n=116). Hastaların demografik karakteristikleri, klinik bilgileri ve tedavi özellikleri hastane otomasyon sistemi aracılığı ile kayıt edilerek her iki grup karşılaştırıldı.
Bulgular: Grup 2’nin yaş ortalaması (50,4 (19,3)), grup 1 (55,4 (20,4))’e göre daha düşüktü ve bu düşüş istatistiksel olarak anlamlıydı (P=0,038). Grupların cinsiyet (P=0,28), malignite (P=0,53), komorbidite (P=0,27) dağılımları benzerdi. Gruplar arasında başvuru şikayetleri (P=0,88) ve şikayet süreleri (P=0,068) açısından anlamlı fark saptanmadı. Grupların tanıları karşılaştırıldığında Grup 2’de akut kolesistit oranı anlamlı olarak daha yüksek tespit edildi (P=0,005). Ayrıca non-spesifik hasta oranı grup 1’de anlamlı olarak daha fazla idi (P=0,003). Gruplar arasında hospitalizasyon (P=0,46), tedavi şekli (P=0,3), yapılan cerrahi prosedür (P=0,27), yatış süresi (P=0,66) ve mortalite oranı (P=0,5) açısından istatistiksel olarak anlamlı bir fark saptanmadı.
Sonuç: Yaptığımız araştırma sonuçlarına göre merkezimize başvuran hastalarda sosyal izolasyona bağlı gelişen ikincil hasarlanma ile karşılaşmadık. Bu dönemde hastaların sosyal izolasyonda olmaları ciddi klinik problemleri var iken hastaneye başvurularını azaltmamış sadece gereksiz acil başvurusu sayısını azaltmıştır.

Kaynakça

  • 1. Tao KX, Zhang BX, Zhang P, Zhu P, Wang GB, Chen XP. Recommendations for general surgery clinical practice in 2019 coronavirus disease situation. Zhonghua Wai Ke Za Zhi. 2020;58(3):170-7. doi: 10.3760/cma.j.issn.0529-5815.2020.03.003.
  • 2. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-60. doi: 10.23750/abm.v91i1.9397.
  • 3. Banerjee D, Rai M. Social isolation in Covid-19: The impact of loneliness. Int J Soc Psychiatry. 2020 Apr 29 [Epub ahead of print], doi: 10.1177/0020764020922269.
  • 4. Plagg B, Engl A, Piccoliori G, Eisendle K. Prolonged social isolation of the elderly during COVID-19: Between benefit and damage. Arch Gerontol Geriatr. 2020;89:104086.. [Epub 2020 May 3] doi: 10.1016/j.archger.2020.104086.
  • 5. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227-37. doi: 10.1177/1745691614568352.
  • 6. https://icd.who.int/browse10/2019/en.
  • 7. https://dosyamerkez.saglik.gov.tr/Eklenti/23238,ek-1-girisimsel-islemler-listesixlsx.xlsx?0.
  • 8. Ellis R, Hay-David AGC, Brennan PA. Operating during the COVID-19 pandemic: How to reduce medical error. Br J Oral Maxillofac Surg. 2020;58(5):577-80. doi: 10.1016/j.bjoms.2020.04.002.
  • 9. Søreide K, Hallet J, Matthews JB, Schnitzbauer AA, Line PD, Lai PBS, et al. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg. 2020 Apr 30. [Epub ahead of print] doi: 10.1002/bjs.11670.
  • 10. Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):14-8. doi: 10.1016/j.jinf.2020.03.005.
  • 11. Kılınç AS, Çatak B, Badıllıoğlu O, Sütlü S, Dikme Ö, Aydın O, et al. Acil servise başvuran yaşlıların başvuru nedenlerinin ve sonuçlarının değerlendirilmesi. S.D.Ü. Tıp Fak. Derg. 2012:19(4):139-43.
  • 12. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. China Medical Treatment Expert Group for COVID-19. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547. doi: 10.1183/13993003.00547-2020.
  • 13. Mathur S, Lim WW, Goo TT. Emergency general surgery and trauma: Outcomes from the first consultant-led service in Singapore. Injury 2018;49(1):130-34. doi: 10.1016/j.injury.2017.09.002.
  • 14. Shakerian R, Thomson BN, Gorelik A, Hayes IP, Skandarajah AR. Outcomes in emergency general surgery following the introduction of a consultant-led unit. Br J Surg. 2015;102(13):1726-32. doi: 10.1002/bjs.9954.
  • 15. Bagla P, Sarria JC, Riall TS. Management of acute cholecystitis. Curr Opin Infect Dis. 2016;29(5):508-13. doi: 10.1097/QCO.0000000000000297.
  • 16. Atlı MM, Yılmaz M, Yaman FN, Kabul S, Yüzügüllü M. Analysıs of patıents leavıng the emergency department on theır own wıll. Balikesir Saglik Bil Derg. 2016;5(2):50-5. doi: 10.5505/bsbd.2016.78309

Does social isolation cause secondary injury in general surgery patients?

Yıl 2020, Cilt: 4 Sayı: 7, 523 - 526, 01.07.2020
https://doi.org/10.28982/josam.773722

Öz

Aim: Social isolation during the pandemic has been reported to cause secondary injury to some patient groups. The fear of secondary injury causes patients and health workers to ignore rules of social isolation. Here we aimed to evaluate secondary injury among general surgery patients during the pandemic.
Methods: In this retrospective cross-sectional study, 279 patients, consulted from emergency departments to general surgery departments at Başkent University Ankara and Konya Research Centers, were analyzed. The patients were divided into two groups according to admission periods (Group 1: March 01 - May 01, 2019; n=163, Group 2: March 01 - May 01, 2020; n=116).
Results: The mean age of Group 2 (50.4 (19.3)) was less than Group 1 (55.4 (20.4)). Gender (P=0.28), malignancy (P=0.53), comorbidity (P=0.27) distributions were similar. There was no significant difference in terms of admission complaints (P=0.88) and complaint durations (P=0.068). Acute cholecystitis rate was significantly higher in Group 2 (P=0.005), and the rate of non-specific patients was significantly higher in Group 1 (P=0.003). Hospitalization (P=0.46), type of treatment (P=0.3), surgical procedure (P=0.27), length of stay (P=0.66) and mortality rate (P=0.5) were similar.
Conclusion: Our results showed no secondary injury to general surgery patients due to the pandemic. During this period, social isolation did not decrease the hospital admission of critically ill patients.

Kaynakça

  • 1. Tao KX, Zhang BX, Zhang P, Zhu P, Wang GB, Chen XP. Recommendations for general surgery clinical practice in 2019 coronavirus disease situation. Zhonghua Wai Ke Za Zhi. 2020;58(3):170-7. doi: 10.3760/cma.j.issn.0529-5815.2020.03.003.
  • 2. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-60. doi: 10.23750/abm.v91i1.9397.
  • 3. Banerjee D, Rai M. Social isolation in Covid-19: The impact of loneliness. Int J Soc Psychiatry. 2020 Apr 29 [Epub ahead of print], doi: 10.1177/0020764020922269.
  • 4. Plagg B, Engl A, Piccoliori G, Eisendle K. Prolonged social isolation of the elderly during COVID-19: Between benefit and damage. Arch Gerontol Geriatr. 2020;89:104086.. [Epub 2020 May 3] doi: 10.1016/j.archger.2020.104086.
  • 5. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227-37. doi: 10.1177/1745691614568352.
  • 6. https://icd.who.int/browse10/2019/en.
  • 7. https://dosyamerkez.saglik.gov.tr/Eklenti/23238,ek-1-girisimsel-islemler-listesixlsx.xlsx?0.
  • 8. Ellis R, Hay-David AGC, Brennan PA. Operating during the COVID-19 pandemic: How to reduce medical error. Br J Oral Maxillofac Surg. 2020;58(5):577-80. doi: 10.1016/j.bjoms.2020.04.002.
  • 9. Søreide K, Hallet J, Matthews JB, Schnitzbauer AA, Line PD, Lai PBS, et al. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg. 2020 Apr 30. [Epub ahead of print] doi: 10.1002/bjs.11670.
  • 10. Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):14-8. doi: 10.1016/j.jinf.2020.03.005.
  • 11. Kılınç AS, Çatak B, Badıllıoğlu O, Sütlü S, Dikme Ö, Aydın O, et al. Acil servise başvuran yaşlıların başvuru nedenlerinin ve sonuçlarının değerlendirilmesi. S.D.Ü. Tıp Fak. Derg. 2012:19(4):139-43.
  • 12. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. China Medical Treatment Expert Group for COVID-19. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547. doi: 10.1183/13993003.00547-2020.
  • 13. Mathur S, Lim WW, Goo TT. Emergency general surgery and trauma: Outcomes from the first consultant-led service in Singapore. Injury 2018;49(1):130-34. doi: 10.1016/j.injury.2017.09.002.
  • 14. Shakerian R, Thomson BN, Gorelik A, Hayes IP, Skandarajah AR. Outcomes in emergency general surgery following the introduction of a consultant-led unit. Br J Surg. 2015;102(13):1726-32. doi: 10.1002/bjs.9954.
  • 15. Bagla P, Sarria JC, Riall TS. Management of acute cholecystitis. Curr Opin Infect Dis. 2016;29(5):508-13. doi: 10.1097/QCO.0000000000000297.
  • 16. Atlı MM, Yılmaz M, Yaman FN, Kabul S, Yüzügüllü M. Analysıs of patıents leavıng the emergency department on theır own wıll. Balikesir Saglik Bil Derg. 2016;5(2):50-5. doi: 10.5505/bsbd.2016.78309
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma makalesi
Yazarlar

Emre Karakaya 0000-0002-4879-7974

Aydıncan Akdur 0000-0002-8726-3369

Tevfik Avcı 0000-0001-5225-959X

Halil İbrahim Taşcı 0000-0003-2269-4798

Nazlı Gülsoy Kirnap 0000-0001-7103-9963

Yayımlanma Tarihi 1 Temmuz 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 4 Sayı: 7

Kaynak Göster

APA Karakaya, E., Akdur, A., Avcı, T., Taşcı, H. İ., vd. (2020). Does social isolation cause secondary injury in general surgery patients?. Journal of Surgery and Medicine, 4(7), 523-526. https://doi.org/10.28982/josam.773722
AMA Karakaya E, Akdur A, Avcı T, Taşcı Hİ, Gülsoy Kirnap N. Does social isolation cause secondary injury in general surgery patients?. J Surg Med. Temmuz 2020;4(7):523-526. doi:10.28982/josam.773722
Chicago Karakaya, Emre, Aydıncan Akdur, Tevfik Avcı, Halil İbrahim Taşcı, ve Nazlı Gülsoy Kirnap. “Does Social Isolation Cause Secondary Injury in General Surgery Patients?”. Journal of Surgery and Medicine 4, sy. 7 (Temmuz 2020): 523-26. https://doi.org/10.28982/josam.773722.
EndNote Karakaya E, Akdur A, Avcı T, Taşcı Hİ, Gülsoy Kirnap N (01 Temmuz 2020) Does social isolation cause secondary injury in general surgery patients?. Journal of Surgery and Medicine 4 7 523–526.
IEEE E. Karakaya, A. Akdur, T. Avcı, H. İ. Taşcı, ve N. Gülsoy Kirnap, “Does social isolation cause secondary injury in general surgery patients?”, J Surg Med, c. 4, sy. 7, ss. 523–526, 2020, doi: 10.28982/josam.773722.
ISNAD Karakaya, Emre vd. “Does Social Isolation Cause Secondary Injury in General Surgery Patients?”. Journal of Surgery and Medicine 4/7 (Temmuz 2020), 523-526. https://doi.org/10.28982/josam.773722.
JAMA Karakaya E, Akdur A, Avcı T, Taşcı Hİ, Gülsoy Kirnap N. Does social isolation cause secondary injury in general surgery patients?. J Surg Med. 2020;4:523–526.
MLA Karakaya, Emre vd. “Does Social Isolation Cause Secondary Injury in General Surgery Patients?”. Journal of Surgery and Medicine, c. 4, sy. 7, 2020, ss. 523-6, doi:10.28982/josam.773722.
Vancouver Karakaya E, Akdur A, Avcı T, Taşcı Hİ, Gülsoy Kirnap N. Does social isolation cause secondary injury in general surgery patients?. J Surg Med. 2020;4(7):523-6.