Full recovery of elective orthopedic surgery in the age of COVID-19: an 8-month retrospective cohort study

Lou, Tengfei; Ren, Zun; Sun, Zhi; Wang, Wei; Fan, Cunyi

doi:10.1186/s13018-021-02286-9

Cited by 8 publications

(11 citation statements)

References 17 publications

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“…Based on projections from 190 countries, estimates suggest that 72.3% of elective surgeries would be cancelled or postponed during a 12-week period of peak disruption due to COVID-19, totalling 28.4 million procedures related to colorectal, head and neck, gynaecological, plastics, upper gastrointestinal and urological surgeries performed in cancer hospitals worldwide 2 . There is also evidence indicating reduction on elective vascular 3 , orthopaedic and trauma 4 , 5 surgeries. As COVID-19 pandemic is far from being solved worldwide, the hospitals’ capacity to deliver elective procedures may continue to be constrained to avoid nosocomial infection, even in periods when there is a declining number of COVID-19 cases and deaths 6 .…”

Section: Introductionmentioning

confidence: 99%

The disruption of elective procedures due to COVID-19 in Brazil in 2020

Frio

Russo

Albuquerque

et al. 2022

Sci Rep

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Elective procedures were temporarily suspended several times over the course of the pandemic of COVID-19. Monthly data from the Unified Health System (SUS) were used for the period between January 2008 and December 2020 and the interrupted time series method was used to estimate the effect of the pandemic on the number of elective surgeries and elective procedures that were not performed. Considering a 9-month period, a reduction of 46% in the number of elective procedures carried out in the SUS could be attributed to COVID-19, corresponding to about 828,429 elective procedures cancelled, ranging from 549,921 to 1,106,936. To a full recovery of pre-pandemic performance, SUS would need to increase about 21,362 hospital beds, ranging from 12,370 to 36,392 hospital beds during a 6 month-period. This effort would represent an increase of 8.48% (ranging from 4.91 to 14.45%) in relation to the total number of SUS’s hospital beds in 2019. As a result, the pandemic will leave a large number of elective procedures to be carried out, which will require efforts by health agencies to meet this demand.

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Section: Introductionmentioning

confidence: 99%

The disruption of elective procedures due to COVID-19 in Brazil in 2020

Frio

Russo

Albuquerque

et al. 2022

Sci Rep

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“…Other groups including operation room technicians and nurses are also at high risks for acquiring COVID-19. Considering that many centers have recovered their number of elective surgeries [ 22 ], immediate measures are needed to address the challenges orthopedic surgeons are facing during the pandemic [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 among patients with orthopedic surgery: our experience from the Middle East

et al. 2021

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Background We report our experiences with COVID-19 in one of the largest referral orthopedic centers in the Middle East and aimed to describe the epidemiology and clinical characteristics of these patients. Methods During February 20 and April 20, 2020, patients who underwent orthopedic surgery and healthcare staff who were in contact with these patients were screened for COVID-19. To identify patients who were in the incubation period of COVID-19 during their hospital stay, all patients were tested again for COVID-19 4 weeks after discharge. Results Overall, 1244 patients underwent orthopedic surgery (1123 emergency and 121 elective) during the study period. Overall, 17 patients were diagnosed with COVID-19 during hospital admission and seven after discharge. Among the total 24 patients with COVID-19, 15 were (62.5%) males with a mean (SD) age of 47.0±1.6 years old. Emergency surgeries were performed in 20 (83.3%) patients, and elective surgery was done in the remaining 4 patients which included one case of posterior spinal fusion, spondylolisthesis, acromioclavicular joint dislocation, and one case of leg necrosis. A considerable number of infections occurred in patients with intertrochanteric fractures (n=7, 29.2%), followed by pelvic fractures (n=2, 8.3%), humerus fractures (n=2, 8.3%), and tibial plateau fractures (n=2, 8.3%). Fever (n=11, 45.8%) and cough (n=10, 37.5%) were the most common symptoms among patients. Laboratory examinations showed leukopenia in 2 patients (8.3%) and lymphopenia in 4 (16.7%) patients. One patient with a history of cancer died 2 weeks after discharge due to myocardial infarction. Among hospital staff, 26 individuals contracted COVID-19 during the study period, which included 13 (50%) males. Physicians were the most commonly infected group (n = 11), followed by operation room technicians (n = 5), nurses (n = 4), and paramedics (n = 4). Conclusions Patients who undergo surgical treatment for orthopedic problems, particularly lower limb fractures with limited ambulation, are at a higher risk of acquiring COVID-19 infections, although they may not be at higher risks for death compared to the general population. Orthopedic surgeons in particular and other hospital staff who are in close contact with these patients must be adequately trained and given appropriate personal protective equipment during the COVID-19 outbreak.

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“…One major reason for protocol development was to ensure that surgical resources are allocated to the correct patient population. Seen in patients in need of orthopedic surgery during the pandemic, protocols were developed to make sure that only necessary emergency surgery were done while others were managed medically until a strain on hospital resources was reduced [27,32]. Another type of protocol that was developed during this time were safety protocols to ensure patients and staff remained safe from the COVID 19 virus.…”

Section: Facilitator To Patient Throughput: Protocol Developmentmentioning

confidence: 99%

“…For healthcare staff taking care of patients in the ambulatory setting, education and training pertained to learning new protocols and guidelines, providing education to patients, learning new technology platforms, and conducting research. At times, each day brought new requirements, warranting the creation of new protocols, methods and learning modules for safe patient care [14,15,20,32,39]. For those ambulatory settings conducting care virtually, new technology tools were implemented, requiring training of staff on how to use the new tools, such as Zoom and Microsoft Teams [15,23].…”

Section: Facilitator To Patient Throughput: Education and Trainingmentioning

confidence: 99%

Patient Throughput Initiatives in Ambulatory Care Organizations during the COVID-19 Pandemic: A Systematic Review

et al. 2021

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Background and objectives: Ambulatory (outpatient) health care organizations continue to respond to the COVID-19 global pandemic using an array of initiatives to provide a continuity of care for both COVID-19 and non-COVID-19 patients. The purpose of this study is to systematically identify the facilitators and barriers experienced by outpatient health care organizations in an effort to maintain effective and efficient patient throughput during the pandemic. Materials and methods: This study systematically reviewed articles focused on initiatives taken by ambulatory care organizations to maintain optimal outpatient throughput levels while balancing pandemic precautions, published during 2020. Results: Among the 30 articles that met the inclusion criteria, three initiatives healthcare organizations have taken to maintain throughput were identified: the use (and enhanced use) of telehealth, protocol development, and health care provider training. The research team also identified three barriers to patient throughput: lack of telehealth, lack of resources, and overall lack of knowledge. Conclusions: To maintain patient throughput during the COVID-19 pandemic, healthcare organizations need to develop strategies such as the use of virtual consultation and follow-up, new guidelines to move patients along the care delivery value-chain, and ongoing training of providers. Additionally, the availability of required technology for telehealth, availability of resources, and adequate knowledge are vital for continuous patient throughput to ensure continuity of care during a pandemic.

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Full recovery of elective orthopedic surgery in the age of COVID-19: an 8-month retrospective cohort study

Cited by 8 publications

References 17 publications

The disruption of elective procedures due to COVID-19 in Brazil in 2020

The disruption of elective procedures due to COVID-19 in Brazil in 2020

COVID-19 among patients with orthopedic surgery: our experience from the Middle East

Patient Throughput Initiatives in Ambulatory Care Organizations during the COVID-19 Pandemic: A Systematic Review

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