How SARS-CoV-2 Pandemic Changed Traumatology and Hospital Setting: An Analysis of 498 Fractured Patients

Abstract

Background: SARS-CoV-2 pandemic is one of the biggest challenges for many health systems in the world, making lots of them overwhelmed by the enormous pressure to manage patients. We reported our Institutional Experience, with specific aims to describe the distribution and type of treated injuries, and the organizational setup of our hospital. Methods: Data of fractured patients admitted for surgical treatment in the time frames 9 March 2020–4 May 2020 and 1 March 2019–31 May 2019 were collected and compared. Furthermore, surgery duration and some parameters of effectiveness in health management were compared. Results: A total of 498 patients were included. Mean age significantly lower age in 2019 and femoral fractures were significantly more frequent 2020. Mean surgery time was significantly longer in 2020. Mortality rate difference between the two years was found to be statistically significant. Time interval between diagnosis and surgery and between diagnosis and discharge/decease was significantly lower in 2020. In 2020, no patient admitted with a negative swab turned positive in any of the following tests for SARS-CoV-2. Conclusions: The COVID-19 pandemic has modified the epidemiology of hospitalized patients for traumatic reasons, leading to an increased admission of older patients with femoral fractures. Nevertheless, our institutional experience showed that an efficient change in the hospital organization, with an improvement of several parameters of effectiveness in health management, led to a null infection rate between patients.

COVID-19 Elderly Patients Treated for Proximal Femoral Fractures during the Second Wave of Pandemic in Italy and Iran: A Comparison between Two Countries

“…This is an important aspect, as we have already previously described how our hospital was able to improve some parameters of hospital clinical efficiency during the first wave of the pandemic. Indeed, in the study of Brayda-Bruno et al, the time frames from diagnosis to surgery and from diagnosis to discharge were analyzed, reporting a reduction in diagnosis-discharge time [22]. The increased length of stay of the Italian patients could even be related to the higher age in the Italian group, as already underlined in the literature, where older age is correlated with a longer length of stay [23,24].…”

How the COVID-19 Pandemic Affected Attendance at a Tertiary Orthopedic Center Emergency Department: A Comparison between the First and Second Waves

“…Our hospital works as a tertiary-level orthopedic center with an ED specialized in minor traumatology. During the Italian lockdown (March–April 2020) our institution was classified as a hub for ‘minor’ trauma, accounting for single-district low-energy trauma that required orthopedic surgical treatment [ 10 ]. Additionally, the majority of outpatient and elective medical practice was suspended or postponed until 4 May, when Italy moved to “phase 2” of progressively reducing reopening of retail establishments, as well as allowing for increasing recreational activity [ 12 ].…”

“…The first wave of COVID-19 spread had catastrophic effects for the whole healthcare system, and several strategies have been implemented to meet the growing demand of intensive care unit beds and to contain the contagion [ 9 ]. The redistribution of health care resources aimed at increasing critical care capacity affected and disrupted clinical, surgical and research activity at many levels [ 10 , 11 , 12 , 13 ]. However, the need for ensuring care continuity did not stop emergency and trauma surgery, although they required a modulation of their activities to be adapted to the pandemic outbreak [ 14 , 15 ].…”

Knee Pathology before and after SARS-CoV-2 Pandemic: An Analysis of 1139 Patients

“…The reopening of the retail trade instead was scheduled for 18 May 2020. Therefore, in our hospital, we adjusted healthcare activities considering the particular historical moment and a reorganization of the assistance activities was mandatory [2,4,5]. During the March-April 2020 lockdown, our Regional Health System was reorganized following the Hub-Spoke model [6,7].…”

“…During the March-April 2020 lockdown, our Regional Health System was reorganized following the Hub-Spoke model [6,7]. In this context, our institution was identified as a hub for 'minor' trauma, defined as low-energy, single-district trauma requiring an orthopedic surgical treatment [5]. All outpatient and elective surgery activities were temporally suspended until Italy moved to "phase 2".…”