Response of Cardiac Surgery Units to COVID-19
Notice bibliographique
Résumé
The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented global effect on health care.We quantified the experience and changes implemented in response to the COVID-19 pandemic across cardiac surgery centers participating in an international research consortium.A 40-question questionnaire was e-mailed to all centers participating in the international ROMA trial (Randomized Comparison of the Outcome of Single Versus Multiple Arterial Grafts) 1 on March 23, 2020.Participation was voluntary and anonymized.The questionnaire assessed each center's pandemic response according to regional disease prevalence; local resources and logistics; and institutional, regional, or national policies.The numbers of infections by country were obtained from the Johns Hopkins Coronavirus Resource Center 2 and adjusted by population size per million inhabitants.We used incidence data contemporary to the date of surveys compilation.Correlations between the adjusted number of COVID-19 infections and survey variables were calculated using the Pearson correlation coefficient.The study did not require institutional review board approval.Of the 61 centers approached, 60 (98.3%) completed the survey: 7 from Asia, 2 from Australia, 31 from Europe, 16 from North America, and 4 from South America.Of the survey responses, 57 out of 60 (95%) came from cardiac surgeons holding an administrative leadership position at their center.The median reduction in cardiac surgery case volume was 50% to 75%, correlating with the number of local of COVID-19 cases (correlation coefficient [r]=0.36;P<0.001).A third of the centers reported >50% reduction in the number of dedicated cardiac operating rooms and intensive care unit beds.Most centers restricted cardiac surgery activity to urgent and emergent cases; 5% had canceled all cases including emergencies.Almost a third of the centers relocated personnel to other departments; the majority was relocated to the intensive care unit, highly correlating (r=0.86,P<0.001) with the local number of COVID-19 infections.Half of the centers still permitted fellows and residents to participate in cardiac surgeries, and about half had suspended all research activity.There was no significant difference between continents with respect to relocation of personnel or suspension of cardiac surgery research.South American centers reported lesser reductions in cardiac surgery case volume (P=0.02).Asian centers more frequently were performing elective surgery (P=0.03).There was no statistically significant difference between low-(≤25th percentile) and high-volume (≥75 th percentile) centers in terms of case volume reduction, personnel relocation, suspension of research, or allowed cardiac surgery activity.Most centers discussed ethical issues around decision making during a surge that would overwhelm all healthcare services.Almost all centers instituted protocols to restrict visitors to their cardiac surgery unit, and one third continued to perform in-person patient follow-up.A majority of centers anticipated that the restrictions preventing full cardiac surgery activity would last >1 month (Table ).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».