Pengaruh Masa Pandemi Covid-19 terhadap Operasi Elektif Obstetri dan Ginekologi di RSUP Dr. Hasan Sadikin Tahun 2020-2021

Abstract

Tujuan: Pandemi COVID-19 memengaruhi semua bidang termasuk operasi karena sekitar 19% kematian akibat COVID-19 berhubungan dengan operasi elektif. Studi ini bertujuan untuk melihat pengaruh pandemi COVID-19 terhadap operasi elektif obstetri dan ginekologi (Obgin) di RSUP Dr. Hasan Sadikin (RSHS) Bandung, Indonesia.
Metode: Studi ini menyajikan data retrospektif operasi elektif Obgin di RSHS selama dua tahun (Januari 2020 - Desember 2021) kemudian dilakukan analisis.
Hasil: Angka pembatalan operasi tahun 2020 adalah 20 (3,6%) dari 561 jadwal operasi: 7 (1,3%) akibat COVID-19 dan 13 (2,3%) penyebab lainnya. Pembatalan operasi tahun 2021 sebanyak 48 (6,5%) dari 737 jadwal operasi: 35 (4,8%) akibat COVID-19 dan 13 (1,7%) penyebab lainnya. Penggunaan ruang rawat intensif (ICU) tahun 2020 (14/541) memiliki angka lebih rendah dibandingkan dengan tahun 2021 (7/689). Tidak ada penjadwalan operasi pada bulan April tahun 2020. Jumlah pembatalan operasi terbanyak terjadi pada periode Mei-Agustus 2021. Pasien yang terdiagnosis COVID-19 dengan komorbid cenderung memiliki nilai CT (cycle threshold) value lebih rendah dan penjadwalan ulang operasi lebih lama. Mortalitas terjadi pada pasien komorbid.
Kesimpulan: Jumlah operasi elektif Obgin di RSHS tahun 2021 lebih banyak dibandingkan tahun 2020 meskipun lebih banyak jumlah pembatalan operasi akibat COVID-19. Penggunaan ruang intensif pasca operasi menurun pada tahun 2021. Rekomendasi prioritas operasi dibagi menjadi empat kelompok utama. Edukasi dan konseling mengenai risiko penundaan operasi dibandingkan risiko peningkatan mortalitas dan morbiditas perioperatif akibat COVID-19 perlu disampaikan.

Impact Of Covid-19 Pandemic on the Implementation of Elective Obstetrics And Gynecologic Surgery at Dr. Hasan Sadikin Hospital in 2020-2021

Abstract
Objective: The COVID-19 pandemic affects all fields, including surgery, as 19% of COVID-19 deaths correlate with elective surgery. This study aims to examine the effect of  COVID-19 pandemic on obstetrics and gynecology elective surgery at Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
Methods: This study presented retrospective data on obstetrics and gynecologic surgery at Dr. Hasan Sadikin Hospital for two years (January 2020 - December 2021).
Result: The number of surgery cancellations in 2020 was 20 (3.6%) out of 561 scheduled surgeries: 7 (1.3%) due to Covid-19 and 13 (2.3%) other causes. The surgery cancellations in 2021 was 48 (6.5%) of the 737 scheduled surgeries: 35 (4.8%) due to COVID-19 and 13 (1.7%) other causes. Use of intensive care rooms (ICU) in 2020 (14/541) was lower compared to 2021 (7/689). There was no surgery scheduled for April 2020. The highest number of surgery cancellations occurred in the period of May-August 2021. Patients diagnosed with COVID-19 and comorbidities tend to have lower CT (cycle threshold) values and longer surgery rescheduling. Mortality occurs in patients with comorbidities.
Conclusion: The number of obstetrics and gynecologic surgery at Dr. Hasan Sadikin Hospital in 2021 was higher than in 2020, although the number of surgery cancellations due to COVID-19 was higher. Use of ICU after elective surgery decreased in 2021. Recommendations for elective surgeries priority during the COVID-19 pandemic were divided into four groups. Education and counseling regarding the risk of surgery delays compared to the risk of increased perioperative mortality and morbidity due to COVID-19 needed to be delivered.

Key words: COVID-19, elective surgery, obstetrics, gynecology