Impact of the COVID-19 Pandemic on the Activity of a Public Orthopedics and Traumatology Service: Our Insights After the First Wave
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Published:
Dec 16, 2021
Keywords:
COVID-19, orthopaedics and traumatology, epidemiology, activity
Main Article Content
Abstract
Introduction: Our aim was to compare our activity in the Orthopedics and Traumatology service during the first wave of the COVID-19 pandemic.
Materials and Methods: Ambispective longitudinal observational analytical study of patients treated in the Orthopedics and Traumatology Service of a public health hospital of Buenos Aires during the first wave of the COVID-19 pandemic. The primary outcome variable was the total number of surgeries performed during the study period.
Results: The pandemic was associated with fewer total surgeries (p = 0.002), emergency department surgeries (p = 0.000) and elective surgeries (p = 0.002). Total surgeries were reduced by 81.5%. Emergency surgeries accounted for 97%, a significant difference with the non-pandemic period (p = 0.080). Additionally, the average number of surgeries per available surgical day was significantly lower (p = 0.000).
Conclusions: We believe that, under the regulations indicated by the national and regional pandemic contingency plan, the care of orthopedic pathology and musculoskeletal trauma was notoriously lower than our usual performance. Although we responded adequately to the emergencies of our specialty, the possibility of stratifying and considering types of patients with conditions that could be treated gradually during the pandemic remains pending.
Materials and Methods: Ambispective longitudinal observational analytical study of patients treated in the Orthopedics and Traumatology Service of a public health hospital of Buenos Aires during the first wave of the COVID-19 pandemic. The primary outcome variable was the total number of surgeries performed during the study period.
Results: The pandemic was associated with fewer total surgeries (p = 0.002), emergency department surgeries (p = 0.000) and elective surgeries (p = 0.002). Total surgeries were reduced by 81.5%. Emergency surgeries accounted for 97%, a significant difference with the non-pandemic period (p = 0.080). Additionally, the average number of surgeries per available surgical day was significantly lower (p = 0.000).
Conclusions: We believe that, under the regulations indicated by the national and regional pandemic contingency plan, the care of orthopedic pathology and musculoskeletal trauma was notoriously lower than our usual performance. Although we responded adequately to the emergencies of our specialty, the possibility of stratifying and considering types of patients with conditions that could be treated gradually during the pandemic remains pending.
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Ricciardi, G. A., Locaso, F., Pérez, M. A., Soto Arriaga, S., Scalambro, S., Salinas, A. A., Riva, M., Elorza, A., Mansilla, D., Molina, F., Urrica, J., Ricciardi, G., Manterola, S., Garfinkel, I. G., Carrioli, G. G., & Ricciardi, D. O. (2021). Impact of the COVID-19 Pandemic on the Activity of a Public Orthopedics and Traumatology Service: Our Insights After the First Wave. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(6), 716-726. https://doi.org/10.15417/issn.1852-7434.2021.86.6.1341
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Clinical Research
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orthopaedic trauma: A retrospective comparative study from a single university hospital in Italy. Orthop Rev
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https://doi.org/10.1016/j.injury.2020.09.044
20. Maniscalco P, Poggiali E, Quattrini F, Ciatti C, Magnacavallo A, Caprioli S, et al. The deep impact of novel
CoVID-19 infection in an Orthopedics and Traumatology Department: the experience of the Piacenza Hospital. Acta Biomed 2020;91(2):97-105. https://doi.org/10.23750/abm.v91i2.9635
21. DiFazio LT, Curran T, Bilaniuk JW, Adams JM, Durling-Grover R, Kong K, et al. The impact of the COVID-19
pandemic on hospital admissions for trauma and acute care surgery. Am Surg 2020;86(8):901-3.
https://doi.org/10.1177/0003134820939904
22. Alyami AH, Alyami AA, AlMaeen BN. Impact of COVID-19 on orthopedic surgery: Experience from Saudi Arabia. Ann Med Surg (Lond) 2020;56:61-3. https://doi.org/10.1016/j.amsu.2020.05.048
23. Maryada VR, Mulpur P, Guravareddy AV, Pedamallu SK, Vijay Bhasker B. Impact of COVID-19 pandemic
on orthopaedic trauma volumes: a multi-centre perspective from the State of Telangana. Indian J Orthop
2020;54(Suppl 2):1-6. https://doi.org/10.1007/s43465-020-00226-z
24. Wong J, Cheung K. Impact of COVID-19 on Orthopaedic and Trauma Service: An epidemiological study. J Bone
Joint Surg Am 2020;102(14):e80. https://doi.org/10.2106/JBJS.20.00775
A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382(8):727-33.
https://doi.org/10.1056/NEJMoa2001017
2. World Health Organization Press Conference. The World Health Organization (WHO) has officially named the
disease caused by the novel coronavirus as COVID-19. [Consulta: 11 de febrero, 2020] Disponible en:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
3. Emergencia Sanitaria. Decreto 260/2020 DECNU-2020-260-APN-PTE - Coronavirus (COVID-19). Boletín Oficial
de la República Argentina, edición Nº 34.327 de la Primera Sección del jueves 12 de marzo de 2020. Disponible en: https://www.boletinoficial.gob.ar/detalleAviso/primera/5217883/20200312?suplemento=1
4. Chang Liang Z, Wang W, Murphy D, Po Hui JH. Novel coronavirus and orthopaedic surgery: early experiences
from Singapore. J Bone Joint Surg Am 2020;102(9):745-9. https://doi.org/10.2106/JBJS.20.00236
5. Rodrigues-Pinto R, Sousa R, Oliveira A. Preparing to perform trauma and orthopaedic surgery on patients with
COVID-19. J Bone Joint Surg Am 2020;102(11):946-50. https://doi.org/10.2106/JBJS.20.00454
6. Ashford RU, Nichols JS, Mangwani J. Annotation: The COVID-19 pandemic and clinical orthopaedic and trauma
surgery. J Clin Orthop Trauma 2020;11(3):504-5. https://doi.org/10.1016/j.jcot.2020.04.002
7. Liang ZC, Ooi S. COVID-19: A Singapore orthopedic resident’s musings in the Emergency Department. Acad
Emerg Med 2020;27(4):349-50. https://doi.org/10.1111/acem.13970
8. Massey PA, McClary K, Zhang AS, Savoie FH, Barton RS. Orthopaedic surgical selection and inpatient paradigms
during the coronavirus (COVID-19) pandemic. J Am Acad Orthop Surg 2020;28(11):436-50.
https://doi.org/10.5435/JAAOS-D-20-00360
9. Randelli PS, Compagnoni R. Management of orthopaedic and traumatology patients during the coronavirus disease (COVID-19) pandemic in northern Italy. Knee Surg Sports Traumatol Arthrosc 2020;28(6):1683-9.
https://doi.org/10.1007/s00167-020-06023-3
10. Prada C, Chang Y, Poolman R, Johal H, Bhandari M. Best practices for surgeons-COVID-19 evidence-based
scoping review. A unifying report of global recommendations. [Consulta: 4 de abril, 2020] Disponible en:
https://aaot.org.ar/wp-content/uploads/2020/04/OE-Best-Practices-for-Surgeons-COVID-19-Evidence-Based-Scoping-Review.pdf_compressed1.pdf Asoc Argent Ortop Traumatol 2021; 86 (6): 716-726 • ISSN 1852-7434 (en línea)
11. Vaccaro AR, Getz CL, Cohen BE, Cole BJ, Donnally CJ 3rd. Practice management during the COVID-19
pandemic. J Am Acad Orthop Surg 2020;28(11):464-70. https://doi.org/10.5435/JAAOS-D-20-00379
12. SECOT. Recomendaciones generales de la Sociedad Española de Cirugía Ortopédica y Traumatología frente a la COVID-19. 2020. [Consulta: 24 de marzo, 2020] Disponible en: https://www.secot.es/media/docs/covid19
13. NHS England and NHS Improvement. Clinical guide for the management of trauma and orthopaedic patients during the coronavirus pandemic. [Consulta: 14 de abril, 2020] Disponible en:
https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0274-Specialty-guide-Orthopaedictrauma-v2-14-April.pdf
14. British Orthopaedic Association. Management of patients with urgent orthopaedic conditions and trauma during the coronavirus pandemic. [Consulta: 13 de abril, 2020] Disponible en:
https://www.boa.ac.uk/resources/covid-19-boasts-combined.htm
15. COVID-19 Guidelines for Triage of Orthopaedic Patients. American College of Surgeons. [Consulta: 4 de abril,
2020] Disponible en: https://www.facs.org/covid-19/clinical-guidance/elective-case/orthopaedics
16. Guidance for surgeons working during the COVID-19 pandemic from the Surgical Royal Colleges of the United Kingdom and Ireland. [Consulta: 20 de marzo, 2020] Disponible en:
https://www.rcseng.ac.uk/coronavirus/joint-guidance-for-surgeons-v1/
17. Ricciardi GA, Pérez MA, Scalambro S, Ricciardi G, Carrioli GG, Locaso F, et al. Propuesta para formular una
estrategia de contingencia en Ortopedia y Traumatología frente a la pandemia de COVID-19. Rev Asoc Arg Ortop
Traumatol 2020;85(3):283-94. https://doi.org/10.15417/issn.1852-7434.2020.85.3.1106
18. Andreozzi V, Marzilli F, Muselli M, Previ L, Cantagalli MR, Princi G, et al. The impact of COVID-19 on
orthopaedic trauma: A retrospective comparative study from a single university hospital in Italy. Orthop Rev
2021;12(4):8941. https://doi.org/10.4081/or.2020.8941
19. Battiato C, Berdini M, Luciani P, Gigante A. Impact of coronavirus disease 2019 (COVID-19) on the epidemiology of orthopedics trauma in a region of central Italy. Injury 2020;51(12):2988-9.
https://doi.org/10.1016/j.injury.2020.09.044
20. Maniscalco P, Poggiali E, Quattrini F, Ciatti C, Magnacavallo A, Caprioli S, et al. The deep impact of novel
CoVID-19 infection in an Orthopedics and Traumatology Department: the experience of the Piacenza Hospital. Acta Biomed 2020;91(2):97-105. https://doi.org/10.23750/abm.v91i2.9635
21. DiFazio LT, Curran T, Bilaniuk JW, Adams JM, Durling-Grover R, Kong K, et al. The impact of the COVID-19
pandemic on hospital admissions for trauma and acute care surgery. Am Surg 2020;86(8):901-3.
https://doi.org/10.1177/0003134820939904
22. Alyami AH, Alyami AA, AlMaeen BN. Impact of COVID-19 on orthopedic surgery: Experience from Saudi Arabia. Ann Med Surg (Lond) 2020;56:61-3. https://doi.org/10.1016/j.amsu.2020.05.048
23. Maryada VR, Mulpur P, Guravareddy AV, Pedamallu SK, Vijay Bhasker B. Impact of COVID-19 pandemic
on orthopaedic trauma volumes: a multi-centre perspective from the State of Telangana. Indian J Orthop
2020;54(Suppl 2):1-6. https://doi.org/10.1007/s43465-020-00226-z
24. Wong J, Cheung K. Impact of COVID-19 on Orthopaedic and Trauma Service: An epidemiological study. J Bone
Joint Surg Am 2020;102(14):e80. https://doi.org/10.2106/JBJS.20.00775