The influence of the COVID-19 pandemic on the work of the Department of Ear, Nose, Throat and Head and Neck Surgery in University Hospital Centre Zagreb

Autori:

Dinko Leović , Borna Miličić, Ika Gugić Radojković, Snežana Vorona, Mario Bilić, Igor Blivajs, Josip Markešić, Iva Botica, Irena Ivković, Juraj Lukinovi, Krešimir Gršić, Ratko Prstačić, Drago Prgomet

Sažetak
Ciljevi: Cilj ovog istraživanja bio je prikazati utjecaj pandemije COVID-19 na rad Klinike za bolesti uha, nosa i grla i kirurgiju glave i vrata KBC-a Zagreb. Metode: Iz računalne baze podataka KBC-a Zagreb te baze onkoloških bolesnika Klinike retrospektivno su izvučeni te uspoređeni podatci o izvršenim postupcima i dijagnozama u razdoblju prva četiri mjeseca 2019., 2020. te 2021. godine. Rezultati: Ukupan je broj slučajeva 2020. bio veći za 32,4%, a 2021. za 13,19% (p<0,001), u usporedbi s 2019. godinom. Odjel za kirurgiju glave i vrata zabilježio je pad od 31,9%, Odjel za dječju otorinolaringologiju 41,89%, Odjel za otologiju 66,67% te Odjel za rinosinusologiju 82,47%. Odjel za maksilofacijalnu kirurgiju te Zavod za tumore glave i vrata zabilježili su porast slučajeva, 71,08% odnosno 31,1%. Pregledom dijagnoza zabilježen je manji broj poremećaja štitnjače (–57,14%), devijacija nazalnog septuma (–85,14%), bolesti srednjeg uha i mastoida (–75,35%), tonzila i adenoida (–52,64%). Porastao je broj tumora glave i vrata (165,4%), prijeloma kostiju lica (95%) te rascjepa usne i nepca, kojih je u 2021. bilo 19, a nijedan u prethodne dvije godine. Novodijagnosticiranih karcinoma grkljana bilo je 2021. za 35% više nego 2019. godine. Broj karcinoma grkljana T1 bio je 2021. manji za 22,2%, dok je broj T2 bio veći za 133%. Zaključak: Ovim radom prikazali smo smanjenje ukupnog broja postupaka u prvoj trećini 2020. i 2021. godine u odnosu na 2019., ali i značajan porast kompleksnosti operacija i broja postupaka bolesnika s tumorima glave i vrata. Iz naših rezultata pokazano je kako je zbrinjavanje znatno većeg broja bolesnika kirurgije glave i vrata moguće i u izvanrednim uvjetima u ustanovi koja je kadrovski i tehnološki kvalitetno opremljena. To ukazuje na važnost razvijanja centara izvrsnosti koji i u slučaju povećanog pritiska na zdravstveni sustav mogu osigurati najviše standarde liječenja kompleksnih bolesnika.
Summary

Aim: The aim of this study was to show changes in the work of the Ear, Nose, Throat and Head and Neck Surgery Department, UHC Zagreb, during the COVID-19 pandemic. Methods: We retrospectively extracted and compared the data on the procedures and diagnoses of the Department during the period from January 1st to April 30th in 2019, 2020 and 2021. Results: The total number of cases was lower by 34.2% in 2020, and by 13.19% in 2021, compared to 2019 (p<0.001). The Head and Neck Surgery Division recorded a decrease of 31.9%, Division of Children’s Otolaryngology 41.9%, Otology Division 66.7%, and Rhinosinusology Division 82.5%. Maxillofacial Surgery Division and Head and Neck Tumours Divisions recorded an increase of 71.1% and 31.1%, respectively. The review of diagnoses revealed a decrease in the number of thyroid disorders (–57.1%), nasal septum deviations (–85.1%), middle ear and mastoid process diseases (–75.35%), and diseases of the tonsils (–52.6%). There was an increase in the number of head and neck tumours (165.4%), facial bones fractures (95%), and cleft lip and palate (19 in 2021, none in 2019 and 2020). There were 35% more newly diagnosed laryngeal cancers in 2021 than in 2019. The number of T1 laryngeal cancers was lower by 22.2%, while the number of T2 increased by 133%. Conclusions: This study showed the decrease in the overall number of procedures since the start of the pandemic, but also an incremental increase in the complexity and the number of oncological surgical procedures. Our results demonstrated that managing the increased number of complex head and neck surgery patients is possible even in the extraordinary conditions in the well organised and equipped institution. This points to the importance of developing centres of excellence, which can provide the high standards of treatment even when the health care system is under increased pressure.

Volumen: 7-8, 2021

Liječ Vjesn 2021;143:241–247

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