Development of Case Numbers during the COVID-19 Pandemic in a Center of Maximum-Care for Traumatology and Orthopedic Oncology

Abstract

(1) Background: The COVID-19 pandemic has led to a significant change in the utilization of trauma surgery and tumor orthopedic hospital facilities. (2) Methods: In a monocentric retrospective analysis, the weekly numbers of cases requiring intra-clinical treatment in the first four months of 2020 were compared with those of 2019. Patients’ visits to the emergency department and shock room, consultation hours, work-related accidents, case numbers in the normal and intensive care units, ventilation hours, the “Simplified Acute Physiology Score/ Therapeutic Intervention Scoring System” (SAPS/TISS), the average length of stay in hospital, the number of operations and their degree of urgency, as well as deaths, were analyzed in a study based on the data from 7606 outpatient consultations in 2019 and 6755 in 2020, as well as 993 inpatient cases in 2019 and 950 in 2020. (3) Results: There was a significant reduction in the number of treatments per week in the emergency department (261 ± 29 vs. 165 ± 25; p < 0.001) with the same number of shock room treatments and fewer consultation hour contacts (226 ± 29 vs. 119 ± 65; p = 0.012). There were fewer inpatient cases (66 ± 7 vs. 42 ± 11; p = 0.001), resulting in a fall in the days of hospitalization (492 ± 63 vs. 308 ± 78; p < 0.001) and number of operations (73 ± 7 vs. 55 ± 10; p = 0.012), especially elective procedures (20 ± 3 vs. 7 ± 7; p = 0.008). The SAPS/TISS score was lower (1351 ± 1213 vs. 399 ± 281; p = 0.023). Fewer fracture treatments and septic surgeries were performed, while the number of procedures to treat orthopedic malignancies remained constant. (4) Conclusions: During the first phase of the COVID-19 pandemic, we observed a significant reduction in the number of cases treated in orthopedics. While the number of multiple-injured patients was unchanged, fewer patients presented for primary and regular care. Treatment of acute injuries and malignant tumor diseases was not at risk. There was no effect on in-house mortality. We see a potential for the recruitment of medical staff from the outpatient department, operating room, and the ward. In the event of a future second wave, our results may allow for early planning, particularly of the all-important human resources. Reorganization by hospitals and decreased patient numbers in trauma surgery can enable the reallocation of medical staff, equipment, and beds to increase capacity for COVID-19 patients.

Geriatric Proximal Femur Fractures During the Covid-19 Pandemic - Fewer Cases, But More Comorbidities

“… 16 However, most of the geriatric proximal femur fractures included in this study occurred as the result of minor trauma (95%) and in the home environment (81%) without the direct influence of road traffic. It was observed that during the onset of the COVID-19 pandemic not only the overall number of trauma patients presenting in the emergency room decreased significantly, 14 but also that of patients with heart attacks and strokes. 17 - 20 Nevertheless, it is highly unlikely that geriatric patients with proximal femur fractures would not present in the emergency department as this injury is usually associated with intolerable pain and immobility.…”

“…A marked drop in the overall number of orthopedic outpatients and inpatients was seen during the first phase of the corona pandemic. 13 , 14 Especially among young people, the number of injuries to the upper extremity due to work, sports and traffic accidents decreased due to a reduction in the volume of traffic and suspension of team sports, while injuries caused by accidents in the home increased. 15 …”

“…12 A marked drop in the overall number of orthopedic outpatients and inpatients was seen during the first phase of the corona pandemic. 13,14 Especially among young people, the number of injuries to the upper extremity due to work, sports and traffic accidents decreased due to a reduction in the volume of traffic and suspension of team sports, while injuries caused by accidents in the home increased. 15 In this study, we investigated the case numbers of geriatric patients with proximal femur fractures during the first wave of the COVID-19 pandemic compared to 2019, shifts in comorbidities and the impact of the pandemic on hospitalization and further treatment.…”

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

“…Concerning surgeries and loco-regional therapies, 106 indicators were identified from 30 articles [42,48–51,55,62,65,65,75,81,90,92–94,97–99,101–103,111,118–125]. Of those, 82 indicators (79%) showed a reduction in the number of treatment procedures, namely in Italy, France, Germany, Ireland, Netherlands, Spain, Turkey, UK, US, Australia, and in 1 international study.…”

Einfluss der COVID-19-Pandemie auf die Frakturepidemiologie am Beispiel der Tibiaplateaufraktur

“…Interessanterweise trifft der Rückgang der Inzidenz nicht auf die „fragility fractures“ und osteoporoseassoziierten Frakturen zu [ 18 ]. Weiterhin zeigt die Literatur einen Rückgang der Arbeitsunfälle und polytraumatisierter Patienten in Pandemiezeiten [ 13 , 14 ].…”