Abstract
Background
The COVID-19 pandemic profoundly impacted the delivery of care and timing of elective surgical procedures. Most endocrine-related operations were considered elective and safe to postpone, providing a unique opportunity to assess clinical outcomes under protracted treatment plans.
Methods
American Association of Endocrine Surgeon members were surveyed for participation. A REDCap survey was developed and distributed to 27 institutions to assess the impact of COVID-19-related delays. Information collected included patient demographics, primary diagnosis, resumption of care, and assessment of disease progression by the surgeon.
Results
Twelve out of 27 institutions completed the survey (44.4%). Of 850 patients, 74.8% (636) were female; median age was 56 (IQR 44-66) years. 4.0% (34) of patients, had not been seen since their original surgical appointment was delayed. 86.2% (733) of patients had a delay in care with women more likely to have a delay (87.6% vs. 82.2% of men, =3.84, p=0.05). Median length of delay was 70 (IQR 42-118) days. Among patients with a delay in care, primary disease site included thyroid (54.2%), parathyroid (37.2%), adrenal (6.5%), and pancreatic/GI neuroendocrine tumors (1.3%). 4.0% (26) of patients experienced disease progression and 4.1% (24) had a change from the initial operative plan. Length of delay was not associated with disease progression (p=0.96) or a change in operative plan (p=0.66).
Conclusion
While some patients experienced disease progression during COVID-19 delays to endocrine disease-related care, most patients with follow-up did not. Our analysis indicates that temporary delay may be an acceptable course of action in extreme circumstances for most endocrine-related surgical disease.
【저자키워드】 COVID-19, Thyroid, Adrenal, endocrine surgery, delay in care, parathyroid, 【초록키워드】 Treatment, COVID-19 pandemic, Diagnosis, surgical, Clinical outcome, Disease progression, Patient, Follow-up, women, disease, Care, patients, Analysis, Endocrine, Safe, demographics, neuroendocrine tumor, surgeon, median age, while, MOST, men, operative, initial, extreme, Course, Result, collected, indicate, unique, impacted, Length, IQR, 【제목키워드】 surgery, Delay, Limited,