Clinical Characteristics and Outcomes of Elective Gynecologic Cases Using Modified Medically Necessary, Time Sensitive (MeNTS) Scoring System in the Prioritization of Surgery at the Philippine General Hospital during the COVID-19 Pandemic.

Abstract

The use of a scoring system that integrates various factors helps in decision-making and triage for Medically Necessary, Time Sensitive (MeNTS) surgical procedures during the COVID-19 pandemic. This study aimed to determine the clinical characteristics and outcomes of cases who were screened and underwent elective gynecologic surgery at a tertiary hospital using the MeNTS tool for prioritization. A cross-sectional study was carried out using data collected through medical chart review of all gynecologic cases screened in a 6-month period, from June 18, 2020 to December 18, 2020. A total of 155 gynecologic cases were screened, with 134 (86.4%) MeNTS cases and 21 (13.5%) non-MeNTS cases. The median length of stay (5 days), the median operating room time (3 hours and 30 minutes), and median estimated blood loss (400 ml) were within the acceptable expected outcome as with the scoring system, albeit with some cases (53%) requiring blood transfusion attributed to low baseline hemoglobin levels. There were no cases with post-operative COVID-19 transmission, needing ICU care and intubation, nor mortalities reported. The MeNTS scoring system allowed efficient handling of the backlog of elective gynecologic cases with minimal morbidity and absence of mortality. The study supports the utility of this scoring system in addressing the need of the healthcare system not just to optimally utilize and fairly allocate hospital resources but also to ensure the safety of the patient with the best health service delivery during the pandemic.