Changes in trends of orthopedic services due to the COVID-19 pandemic: A review

Obamiro, Eunice; Trivedi, Radhika; Ahmed, Nasim

doi:10.5312/wjo.v13.i11.955

Cited by 12 publications

(9 citation statements)

References 38 publications

(61 reference statements)

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“…Considering the reallocation of healthcare resources during the COVID-19 pandemic, the primary objective was to provide medical care to the maximum number of people while preventing potential viral transmission that could arise from surgical treatment delays [ 50 ]. The decrease in time to surgery, as reported by some authors, including the present study, exemplifies the efforts made to prioritize the urgent treatment of hip fractures [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…This reduction in time to surgery also possibly highlights the benefits of quarantine measures for healthcare system capacity, as they effectively offloaded theaters by reducing surgical trauma, due to restricted mobility, and by canceling elective surgical cases. However, the productivity of the theatre, the allocation of surgical and anesthetic teams, and even the adaptation to complicated aerosol-generating procedures (AGPs) are factors that seem to have affected some hospitals, resulting in delays in operative treatment [ 34 ], while others have managed to overcome these challenges and maintain a high standard of healthcare services [ 38 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of COVID-19 Pandemic on Fragility Fractures of the Hip: An Interrupted Time-Series Analysis of the Lockdown Periods in Western Greece and Review of the Literature

et al. 2023

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Since December 2019, the COVID-19 pandemic has had a significant impact on healthcare systems worldwide, prompting policymakers to implement measures of isolation and eventually adopt strict national lockdowns, which affected mobility, healthcare-seeking behavior, and services, in an unprecedented manner. This study aimed to analyze the effects of these lockdowns on hip-fracture epidemiology and care services, compared to nonpandemic periods in previous years. We retrospectively collected data from electronic patient records of two major hospitals in Western Greece and included patients who suffered a fragility hip fracture and were admitted during the two 5-week lockdown periods in 2020, compared to time-matched patients from 2017–2019. The results showed a drop in hip-fracture incidence, which varied among hospitals and lockdown periods, and conflicting impacts on time to surgery, time to discharge after surgery, and total hospitalization time. The study also found that differences between the two differently organized units were exaggerated during the COVID-19 lockdown periods, highlighting the impact of compliance with social-distancing measures and the reallocation of resources on the quality of healthcare services. Further research is needed to fully understand the specific variations and patterns of geriatric hip-fracture care during emergency health crises characterized by limited resources and behavioral changes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Pandemic on Fragility Fractures of the Hip: An Interrupted Time-Series Analysis of the Lockdown Periods in Western Greece and Review of the Literature

et al. 2023

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“…Previous studies by Pogoreli et al discovered a significant increase in delayed presentations and care among patients with testicular torsion during the COVID-19 pandemic [ 9 ]. Furthermore, orthopedic surgery, considered a relatively non-life-threatening condition, experienced delays in stages to alleviate the strain on healthcare services [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis

Won

Ahn

2023

Medicina

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Background and Objectives: We investigated epidemiological factors and outcomes, including the development of complications, for patients with appendicitis according to three sequential coronavirus disease 2019 (COVID-19) pandemic periods, divided by specific time points. Materials and Methods: This observational study included patients with acute appendicitis who arrived at a single-center between March 2019 and April 2022. The study divided the pandemic into three periods: period A as the first phase of the pandemic (from 1 March 2020 to 22 August 2021), period B as the time period the medical system stabilized (from 23 August 2021 to 31 December 2021), and period C as the time period of the exploration of patients with COVID-19 in South Korea (from 1 January 2022 to 30 April 2022). Data collection was based on medical records. The primary outcome was presence or absence of complications and the secondary outcomes were the time taken from ED visit to surgical intervention, the presence and time of the first administration of antibiotics, and the hospital stay time. Results: Of 1,101 patients, 1,039 were included, with 326 and 711 patients before and during the pandemic, respectively. Incidence of complications was not affected during the pandemic (before the pandemic 58.0%; period A 62.7%; period B,55.4%; and period C 58.1%; p = 0.358). Time from symptom onset to emergency department (ED) arrival significantly decreased during the pandemic (before the pandemic 47.8 ± 84.3 h; pandemic 35.0 ± 54 h; p = 0.003). Time from ED visit to the operating room was statistically significantly increased during the pandemic (before the pandemic 14.3 ± 21.67 h; period A 18.8 ± 14.02 h; period B 18.8 ± 8.57 h; period C 18.3 ± 12.95 h; p = 0.001). Age and time from symptom onset to ED arrival were variables affecting the incidence of complications; however, they were not affected during the pandemic (age, OR 2.382; 95% CI 1.545–3.670; time from symptom onset to ED arrival, OR 1.010, 95% CI 1.006–1.010; p < 0.001). Conclusions: This study found no differences in postoperative complications or treatment durations between pandemic periods. The incidence of appendicitis complications was significantly influenced by age and the duration between the onset of symptoms and arrival at the emergency department, but not by the pandemic period itself.

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“…Further, it has been observed that those overall reductions resulted often from considerable reductions in RTIs [ 16 – 19 ] and, to some extent, in sport and leisure related injuries [ 19 ]. The most common explanation for lowered numbers is that of reduced hazard exposure as a consequence of confinement and mobility restrictions [ 16 , 19 , 23 , 24 ]. While the explanation is very plausible [ 16 , 24 ], it cannot help to explain a rise in the volume of injuries during the same restriction period shown in a few studies [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…As indicated above, restriction periods could also be characterized by shifts in injury patterns [ 18 , 19 , 23 ], reflecting changes in exposure. Most typically, while RTIs went down, confinement measures were associated with an increase in the number (or proportion) of burns [ 26 – 28 ] and violence-related injuries [ 21 , 22 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Changing patterns in the burden of paediatric injuries during the COVID-19 pandemic: a study in Mozambique’s central hospitals

Amado,

Trott,

Möller

et al. 2023

BMC Health Serv Res

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Introduction There is a substantial body of knowledge on the effects of the COVID-19 pandemic on injuries showing frequent but inconsistent reductions in both volume and pattern. Yet, studies specifically addressing children are less common, not least from low- and middle-income countries. This study investigated whether changes in the pattern and outcome of paediatric injury admissions to Mozambique’s four regional referral hospitals during 2020. Methods Clinical charts of paediatric patients presenting to the targeted hospitals with acute injuries were reviewed using a set of child, injury, and outcome characteristics during each of two consecutive restriction periods in 2020 using as a comparator the same periods in 2019, the year before the pandemic. Differences between 2020 and 2019 proportions for any characteristic were examined using the t-test (significance level 0.05). Results During both restriction periods, compared with the previous year, reductions in the number of injuries were noticed in nearly all aspects investigated, albeit more remarkably during the first restriction period, in particular, greater proportions of injuries in the home setting and from burns (7.2% and 11.5% respectively) and a reduced one of discharged patients (by 2.5%). Conclusion During the restrictions implemented to contend the pandemic in Mozambique in 2020, although each restriction period saw a drop in the volume of injury admissions at central hospitals, the pattern of child, injury and outcome characteristics did not change much, except for an excess of home and burn injuries in the first, more restrictive period. Whether this reflects the nature of the restrictions only or, rather, other mechanisms that came into play, individual or health systems related, remains to be determined.

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Changes in trends of orthopedic services due to the COVID-19 pandemic: A review

Cited by 12 publications

References 38 publications

Impact of COVID-19 Pandemic on Fragility Fractures of the Hip: An Interrupted Time-Series Analysis of the Lockdown Periods in Western Greece and Review of the Literature

Impact of COVID-19 Pandemic on Fragility Fractures of the Hip: An Interrupted Time-Series Analysis of the Lockdown Periods in Western Greece and Review of the Literature

Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis

Changing patterns in the burden of paediatric injuries during the COVID-19 pandemic: a study in Mozambique’s central hospitals

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