A prioritization score for elective urological surgery during the COVID-19 pandemic: The Medically Necessary Time-Sensitive (MeNTS) score system

Abstract

Purpose:

The COVID19 pandemic has caused a redistribution of hospital resources. Prioritization strategies are needed in order to organize elective surgeries. We compared the new Medically Necessary Time-Sensitive score (MeNTS) and its factors (disease, procedure, and patient factors) between operated and deferred cases, and also to a subjective priority scale in the Urology department.

Methods:

The MeNTS score and a subjective prioritization scale were prospective applied to all patients included on the surgical waiting list from March 10 to September 9, 2020. Mann-Whitney U test was used to compare MeNTS scores between operated and non-operated groups. Kruskal-Wallis test was used to compare MeNTS scores between three subjective priority groups.

Results:

A total of 150 cases were operated while 100 were deferred. Median total MeNTS score in the operated group was 39.5 whereas in the non-operated group it was 38 (p = 0.135). Median disease factors score was 9.5 in the operated group and 11 in the non-operated group(p = 0.033). Median procedure factors score was 10 in both groups (p = 0.02). Median patient factors score was 17 in the operated group and 18 in the non-operated group (p = 0.210). Disease factors displayed a significant difference between the three subjective priority groups

Conclusions:

Total MeNTS score does not show significant differences between operated and non-operated patients. However, we demonstrate a relationship between MeNTS disease factors and the operated group as well as with the subjective priority scale.