CLINICAL CHARACTERISTICS AND OUTCOMES OF ELECTIVE GYNECOLOGIC CASES USING MODIFIED MEDICALLY NECESSARY, TIME SENSITIVE (MENTS) SCORING SYSTEM IN PHILIPPINE GENERAL HOSPITAL DURING THE COVID-19 PANDEMIC

Problem statement. The use of a scoring system that integrates various factors including COVID-19 transmission risks helps in decision-making and triage for Medically Necessary, Time Sensitive (MeNTS) surgical procedures. 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 a modified MeNTS tool for prioritization. This study aims to answer the question,
did the MeNTS scoring system achieve its objective to facilitate decision-making and triage gynecologic elective cases without compromising safety?

Methods: 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 18 June 2020 to 18 December 2020.

Results. 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 (400ml) 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.

Conclusions: 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.

Declarations:
Competing interests: The authors report no conflict of interests.
Funding: This study has been funded by the authors.

KEY WORDS: MeNTS, Medically necessary time sensitive scoring system, gynecologic elective surgery, COVID-19