INITIAL ANALYSIS, TRIAGE SORTING OF COVID-19 PATIENTS & EMERGENCY SURGERIES IN COMBINED MILITARY HOSPITAL,MULTAN
Objective: To analyze results of triage sorting, weekly turnout of positive cases and their mortality and to see the pattern of emergency surgeries in various disciplines.
Study Design: Cross sectional study.
Place and Study Duration: Department of Surgery, Combined Military Hospital, Multan, from Mar 2020 to Jun 2020.
Methodology: National Institute of Health Pakistan guidelines 2020 on COVID-19, for admissions and contact tracing were adopted. Group A patients were admitted with strong clinical suspicion of COVID-19 based on high risk score. Group B patients presented for contact tracing and Group C were surgical emergencies. Lab, Triage counter and isolation ward records were analyzed.
Results: Out of 408 admitted patients, 293 were males while 115 were females. 167 (40.9%) were positive. 74/167 had comorbid 5 of these died. The case fatality rate was 3% (p-value 0.01). In contact tracing, the secondary attack rate was 2.56%. Maximum positive trend was observed in the last 4 weeks which is consistent with the exponential rise in local and national cases. 424 surgeries were performed and 12 /424 were positive for COVID-19.
Conclusion: Screening of symptomatic patients showed Positive Predictive Value of 41% and sensitivity of 67.6%. Significant number of patients will be missed because of low sensitivity of this method. So, we recommend using Polymerase Chain Reaction as a screening modality. Symptomatic patients are likely to be positive in an area where the incidence of disease is greater.