A prospective study on the incidence of postponed time-sensitive urological procedures during the SARS-CoV-2 pandemic du
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ORIGINAL ARTICLE
A prospective study on the incidence of postponed time-sensitive urological procedures during the SARS-CoV-2 pandemic due to patient preference Aoibhinn McDermott 1 & John O’Kelly 1 & Mark Jack Quinlan 1 & Dilly M. Little 1 & Niall Francis Davis 1,2 Received: 27 October 2020 / Accepted: 13 November 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background The risk of acquiring perioperative SARS-CoV-2 infection is concerning for surgeons and patients. Aims In this study, we investigate the incidence of postponed, medically necessary, time-sensitive urological procedures due to a patient’s unwillingness to proceed to a recommended surgical intervention during the first phase of the SARS-CoV-2 pandemic. Methods We prospectively monitored all patients undergoing elective urological surgery during the initial phase of the SARSCoV-2 pandemic. The primary outcome measurement was incidence of postponed, medically necessary, urological procedures due to the patient’s decision not to proceed to a recommended urological intervention (16th of March–5th of June 2020). The secondary outcome measurements were the type of delayed procedure and duration of postponement. Results During the initial 12-week period of the SARS-CoV-2 pandemic, 155 elective urgent urological procedures were scheduled after pre-operative SARS-CoV-2 screening. In total, 140 procedures were performed and 15 (10%) patients intentionally delayed their urological procedure due to the perceived risk of acquiring nosocomial perioperative SARS-CoV-2 infection. The duration for procedural delays is currently 42 ± 23 (range: 15–80) days. The most frequently postponed procedures among patients unwilling to proceed to surgery are urgent endourological procedures due to symptomatic urolithiasis (n = 7/15). Conclusions The incidence for patients postponing urological procedures due to the risk of acquiring nosocomial SARS-CoV-2 is 10%. Endourological procedures for urolithiasis are the most frequently postponed procedures by patients. This study demonstrates that a subset of patients will decline urgent urological surgery during the SARS-CoV-2 pandemic. Keywords Coronavirus . COVID . COVID-19 . Pandemic . SARS-CoV-2
Abbreviations SARS-CoV-2
Severe acute respiratory virus coronavirus 2
Introduction Healthcare systems across the globe face unprecedented challenges due to the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) pandemic [1]. SARS-CoV-2 has simultaneously high transmission and high mortality rates. To date, many urological centres have prioritised their patients for * Niall Francis Davis [email protected] 1
Department of Urology, Beaumont Hospital, Dublin, Ireland
2
Department of Surgery, The Royal College of Surgeons in Ireland, Dublin, Ireland
urgent surgical intervention due to a reduction in operating theatre availability and due to the risk of hospital acquired SARS-CoV-2 infection [1, 2]. Current epidemiological projections indicate that SARS-CoV-2 may persist for 12– 18 months, and, while most centres hav
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