Public Perceptions of Resuming Elective Surgery During the COVID-19 Pandemic

Moverman, Michael A.; Puzzitiello, Richard N.; Pagani, Nicholas R.; Barnes, C. Lowry; Jawa, Andrew; Menendez, Mariano E.

doi:10.1016/j.arth.2020.07.037

Cited by 34 publications

(58 citation statements)

References 36 publications

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“…The capacity of beds was tested during the year, and the American College of Surgeons guidelines suggested that lower acuity surgery could be performed at ambulatory surgical centres. 10 As other institutions attempted to restart elective work 11 , 12 fears of public perception 13 and protocol to limit the risk of spread have been at the forefront. 14 …”

Section: Introductionmentioning

confidence: 99%

Converting hip and knee arthroplasty cases to same-day surgery due to COVID-19

et al. 2021

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Aims In 2020, the COVID-19 pandemic meant that proceeding with elective surgery was restricted to minimize exposure on wards. In order to maintain throughput of elective cases, our hospital (St Michaels Hospital, Toronto, Canada) was forced to convert as many cases as possible to same-day procedures rather than overnight admission. In this retrospective analysis, we review the cases performed as same-day arthroplasty surgeries compared to the same period in the previous 12 months. Methods We conducted a retrospective analysis of patients undergoing total hip and knee arthroplasties over a three-month period between October and December in 2019, and again in 2020, in the middle of the COVID-19 pandemic. Patient demographics, number of outpatient primary arthroplasty cases, length of stay for admissions, 30-day readmission, and complications were collated. Results In total, 428 patient charts were reviewed for October to December of 2019 (n = 195) and 2020 (n = 233). Of those, total hip arthroplasties (THAs) comprised 60% and 58.8% for 2019 and 2020, respectively. Demographic data was comparable with no statistical difference for age, sex, contralateral joint arthroplasty, or BMI. American Society of Anesthesiologists grade I was more highly prevalent in the 2020 cohort (5.1-times increase; n = 13 vs n = 1). Degenerative disc disease and fibromyalgia were less significantly prevalent in the 2020 cohort. There was a significant increase in same day discharges for non-direct anterior approach THAs (two-times increase) and total knee arthroplasty (ten-times increase), with a reciprocal decrease in next day discharges. There were significantly fewer reported superficial wound infections in 2020 (5.6% vs 1.7%) and no significant differences in readmissions or emergency department visits (3.1% vs 3.0%). Conclusion The COVID-19 pandemic meant that hospitals and patients were hopeful to minimize the exposure to the wards, and minimize strain on the already taxed inpatient beds. With few positives during the COVID-19 crisis, the pandemic was the catalyst to speed up the outpatient arthroplasty programme that has resulted in our institution being more efficient, and with no increase in readmissions or early complications. Cite this article: Bone Jt Open 2021;2(7):545–551.

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Section: Introductionmentioning

confidence: 99%

Converting hip and knee arthroplasty cases to same-day surgery due to COVID-19

et al. 2021

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“…In December 2019, the first case of a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China [1]. The disease caused by SARS-CoV-2 was later named coronavirus disease 2019 (COVID- 19), and on March 11, 2020, WHO declared COVID-19 a pandemic [2]. The first US cases were reported in Seattle, Washington in February, 2020, followed shortly by cases in New York, which quickly became the primary epicenter of the outbreak in the United States [3,4].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic and elective spinal surgery cancelations – what happens to the patients?

et al. 2021

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BACKGROUND CONTEXT: The COVID-19 pandemic caused nationwide suspensions of elective surgeries due to reallocation of resources to the care of COVID-19 patients. Following resumption of elective cases, a significant proportion of patients continued to delay surgery, with many yet to reschedule, potentially prolonging their pain and impairment of function and causing detrimental long-term effects. PURPOSE: The aim of this study was to examine differences between patients who have and have not rescheduled their spine surgery procedures originally cancelled due to the COVID-19 pandemic, and to evaluate the reasons for continued deferment of spine surgeries even after the lifting of the mandated suspension of elective surgeries. STUDY DESIGN/SETTING: Retrospective case series at a single institution PATIENT SAMPLE: Included were 133 patients seen at a single institution where spine surgery was canceled due to a state-mandated suspension of elective surgeries from March to June, 2020. OUTCOME MEASURES: The measures assessed included preoperative diagnoses and neurological dysfunction, surgical characteristics, reasons for surgery deferment, and PROMIS scores of pain intensity, pain interference, and physical function. METHODS: Patient electronic medical records were reviewed. Patients who had not rescheduled their canceled surgery as of January 31, 2021, and did not have a reason noted in their charts were called to determine the reason for continued surgery deferment. Patients were divided into three groups: early rescheduled (ER), late rescheduled (LR), and not rescheduled (NR). ER patients had a date of surgery (DOS) prior to the city's Phase 4 reopening on July 20, 2020; LR patients had a DOS on or after that date. Statistical analysis of the group findings included analysis of variance with Tukey's honestly significant difference (HSD) post-hoc test, independent samples T-test, and chi-square analysis with significance set at p≤.05. RESULTS: Out of 133 patients, 47.4% (63) were in the ER, 15.8% (21) in the LR, and 36.8% (49) in the NR groups. Demographics and baseline PROMIS scores were similar between groups. LR had more levels fused (3.6) than ER (1.6), p= .018 on Tukey HSD. NR (2.1) did not have different mean levels fused than LR or ER, both p= >.05 on Tukey HSD. LR had more three column osteotomies (14.3%) than ER and (1.6%) and NR (2.0%) p=.022, and fewer lumbar microdiscectomies (0%) compared to ER (20.6%) and NR (10.2%), p=.039. Other surgical characteristics were similar

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“…Several studies in other specialties have explored the patient perspective on resuming elective procedures during the pandemic, with mixed results. 12 , 13 , 14 , 15 There are also several orthopedic-specific studies that have examined patient perspectives, with most of them focusing on total joint arthroplasty. 16 , 17 , 18 , 19 These studies have shown varying impacts on patient well-being, progression of disease, and anxiety surrounding elective procedures in the COVID-19 era.…”

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confidence: 99%

Patient Perceptions of COVID-19 Precautions and Their Effects on Experiences With Hand Surgery

Tawfik

Silver

Katt

et al. 2021

Journal of Hand Surgery Global Online

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Purpose The purpose of this study is to evaluate patient perceptions of COVID-19 precautions and how these precautions have affected their hand and upper extremity surgery experience. Methods We sent an 18-item survey to 1,213 patients who underwent elective hand and upper extremity surgery at 1 academic institution from October 2020 to January 2021. The survey consisted of questions related to patient demographics, treatment delays due to COVID-19, and patient perceptions of COVID-19 precautions. Descriptive statistics were performed to analyze the survey responses. Responses for patients aged 18–50 and 51+ were compared using a chi-square analysis for categorical variables and a Student t -test for continuous variables. Results Out of 1,213 invitations, 384 survey respondents completed the survey (31.6%). Of the respondents, 16.8% reported delaying medical treatment for an average of 123.2 days because of COVID-19. The preventative measures were found to be adequate by 95% of patients. Only 2.6% of patients reported experiencing surgical delays due to preoperative COVID-19 testing or other COVID-19-related precautions. COVID-19 testing was seen as necessary by 88% of patients, and 74% did not find COVID-19 testing to be a barrier to their surgery. Patients aged 51+ were more likely to delay seeking medical treatment than younger patients (19.3% vs 9.1%, respectively). Furthermore, those that did delay seeking treatment waited longer on average than their younger counterparts (136.1 vs 72.9 days, respectively). Conclusions In conclusion, patients undergoing hand and upper extremity surgery typically do not find COVID-19 precautions to be a significant barrier to care and understand their importance. Despite this, many patients, particularly older ones, are delaying medical care for extended periods of time. It is important for hand surgeons to acknowledge their patients’ perspectives and work to educate patients on evolving surgical safety guidelines. Clinical relevance Patient perspectives of current COVID-19 precautions can help inform hand surgeons on areas for continued patient education.

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Public Perceptions of Resuming Elective Surgery During the COVID-19 Pandemic

Cited by 34 publications

References 36 publications

Converting hip and knee arthroplasty cases to same-day surgery due to COVID-19

Converting hip and knee arthroplasty cases to same-day surgery due to COVID-19

COVID-19 pandemic and elective spinal surgery cancelations – what happens to the patients?

Patient Perceptions of COVID-19 Precautions and Their Effects on Experiences With Hand Surgery

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