Retina Procedure Volume Changes during the COVID-19 Pandemic

Patel, Shriji; Finn, Arthur L.; Kim, Stephen; Sternberg, Paul W.

doi:10.1016/j.oret.2023.01.016

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…Although RD repairs and procedures for retinal tears decreased during the COVID-19 pandemic, it is uncertain whether this decrease is fully explained by patients who avoided evaluation and treatment from a fear of COVID-19 infection . Multiple specialties, including emergency medicine, neurosurgery, pediatric orthopedics, and cardiology, have experienced decreases in clinical volumes, with attribution to fear of the virus as well as other specialty-dependent explanations .…”

Section: Discussionmentioning

confidence: 99%

Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

et al. 2021

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(AAO) indicated that urgent or emergent vitreoretinal surgical procedures should continue during the coronavirus disease 2019 (COVID-19) pandemic. Although decreases in the frequency of critical procedures have been reported outside the field of ophthalmology, analyses are limited by volume, geography, and time. OBJECTIVE To evaluate whether the frequency of ophthalmic surgical procedures deemed urgent or emergent by the AAO changed across the United States during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS Vitreoretinal practices from 17 institutions throughout the US participated in this multicenter cross-sectional study. The frequency of 11 billed vitreoretinal Current Procedural Terminology (CPT) codes across respective weeks was obtained from each practice between January 1, 2019, and May 31, 2020. Data were clustered into intravitreal injections (code 67028), lasers and cryotherapy (codes 67141, 67145, and 67228), retinal detachment (RD) repairs (codes 67107, 67108, 67110, and 67113), and other vitrectomies (codes 67036, 67039, and 67040). Institutions were categorized by region (Northeast, Midwest, South, and West Coast), practice setting (academic [tax-exempt] or private [non-tax-exempt]), and date of respective statewide stay-at-home orders. MAIN OUTCOMES AND MEASURES Nationwide changes in the frequency of billing for urgent or emergent vitreoretinal surgical procedures during the COVID-19 pandemic. RESULTS A total of 526 536 CPT codes were ascertained: 483 313 injections, 19 257 lasers or cryotherapy, 14 949 RD repairs, and 9017 other vitrectomies. Relative to 2019, a weekly institutional decrease in injections was observed from March 30 to May 2, 2020, with a maximal 38.6% decrease (from a mean [SD] of 437.8 [436.3] to 273.8 [269.0] injections) from April 6 to 12, 2020 (95% CI, −259 to −69 injections; P = .002). A weekly decrease was also identified that spanned a longer interval, at least until study conclusion (March 16 to May 31, 2020), for lasers and cryotherapy, with a maximal 79.6% decrease (from a mean [SD] of 6.6 [7.7] to 1.5 [2.0] procedures) from April 6 to 12, 2020 (95% CI, −6.8 to −3.3 procedures; P < .001), for RD repairs, with a maximal 59.4% decrease (from a mean [SD] of 3.5 [4.0] to 1.6 [2.2] repairs) from April 13 to 19, 2020 (95% CI, −2.7 to −1.4 repairs; P < .001), and for other vitrectomies, with a maximal 84.3% decrease (from a mean [SD] of 3.0 [3.1] to 0.4 [0.8] other vitrectomies) from April 6 to 12, 2020 (95% CI, −3.3 to −1.8 other vitrectomies; P < .001). No differences were identified by region, setting, or state-level stay-at-home order adjustment. CONCLUSIONS AND RELEVANCE Although the AAO endorsed the continued performance of urgent or emergent vitreoretinal surgical procedures, the frequency of such procedures throughout the country experienced a substantial decrease that may persist after the COVID-19 pandemic's initial exponential growth phase. This decrease appears independent of region, setting, and state-level stay-at-home orders. It is unknown to what ex...

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Section: Discussionmentioning

confidence: 99%

Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

et al. 2021

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“…2 Others suggested that early discharge was especially risky because many families were hesitant to seek medical care in an effort to reduce COVID-19 exposure risk, and thus may delay postdischarge follow-up or urgent visits. 3 Benefits to early discharge may include cost reduction, increased availability of hospital beds, and reduced risk for nosocomial infections, particularly COVID-19 for mothers and infants. 4 Length of newborn stay has been controversial and widely studied prior to COVID.…”

Section: Background and Significancementioning

confidence: 99%

Rehospitalization following Discharge from Newborn Nursery during Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic

Ronca,

Vazquez,

Bathory

et al. 2024

Am J Perinatol

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Objective This study aimed to compare rehospitalization rates, diagnoses, and well-baby nursery (WBN) length of stay (LOS) among rehospitalized infants born during the COVID-19 pandemic to those born prior. Study Design A retrospective comparison of 215 infants rehospitalized from March 1, 2019 to March 1, 2021 was performed in an urban academic center. Rates of readmission were determined for all infants using an unadjusted odds ratio. Among infants rehospitalized at ≤30 and ≤7 days, key cohort characteristics were analyzed using chi-square analysis, Fisher's exact test, independent t-test, and nonparametric testing as applicable. Differences in readmission diagnoses determined by International Classification of Diseases (ICD) code and chart review were evaluated with multivariable logistic regression comparing infants born during the pandemic to the year prior. Results Pandemic infants had a 51% increased odds of rehospitalization ≤7 days of discharge from WBN compared with prepandemic infants (95% Confidence Interval (CI) 1.09–2.09). Rehospitalized infants born during the pandemic had shorter WBN LOS; infants rehospitalized ≤30 days had LOS of 54.3 ± 18.6 versus 59.6 ± 16.2 hours (p = 0.02) and infants rehospitalized ≤7 days had LOS of 53.8 ± 17.8 versus 60.8 ±17.0 hours (p = 0.02). The pandemic group of infants had a 3.5 increased odds of being readmitted for hyperbilirubinemia compared with other diagnoses after adjusting for biological sex, ethnicity, percent weight lost at time of discharge, gestational age, and mode of delivery (CI 1.9, 6.4). Conclusion Rehospitalization ≤7 days post-WBN discharge was more common in infants born during the pandemic. Infants rehospitalized during the pandemic were more likely to have shorter WBN LOS and to be rehospitalized for hyperbilirubinemia. Retrospective analyses limit conclusions about causation but suggest that being born during the pandemic increased risk of rehospitalization for hyperbilirubinemia among infants in urban, under resourced setting warranting further investigation. Key Points

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“…Subsequent case surges and new variants of the virus have appeared at different times in different areas of the country, even after vaccines became widely available 6,7 . Patients reported being nervous about going into health care facilities at the height of the pandemic 8 . Additionally, the pandemic created a workforce shortage with hospitals experiencing staffing deficiencies that negatively impacted surgical capacity 9 .…”

Section: Introductionmentioning

confidence: 99%

“…6,7 Patients reported being nervous about going into health care facilities at the height of the pandemic. 8 Additionally, the pandemic created a workforce shortage with hospitals experiencing staffing deficiencies that negatively impacted surgical capacity. 9 The effects of these negative pandemic consequences on the training of FPMRS fellows are unknown.…”

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confidence: 99%

Female pelvic medicine and reconstructive surgery fellows' case logs remained stable during the COVID‐19 pandemic

Daily,

Popat,

Koenig

et al. 2023

Neurourology and Urodynamics

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IntroductionDuring the COVID‐19 pandemic and subsequent staffing shortages there was concern about the case volume, and thus competency, of graduating trainees due to reduced surgical volumes. Elective procedures were particularly affected, which includes Female Pelvic Medicine and Reconstructive Surgery (FPMRS) cases. To understand whether FPMRS fellows were affected, we assessed their case logs for changes during the pandemic.MethodsThe nationally aggregated case logs of graduating FPMRS fellows, both urology and obstetrics and gynecology (OBGYN), were obtained from the Accreditation Council for Graduate Medical Education. The available academic years (AYs) included 2018−2019, 2019−2020, and 2020−2021. Standard deviation for each index category was derived from the average and 90th percentile data. One‐way analysis of variance was used to compare differences in case volumes for tracked index categories between AYs.ResultsGraduating fellows logged an average of 517.4 (standard deviation [SD] 28.6) and 818.0 (SD 37.9) cases, for urology and OBGYN respectively, over their fellowship training during the examined period. No significant differences in total surgical procedures were found for either specialty between pre‐COVID AY 2018−2019 and COVID‐affected AYs 2019−2020 and 2020‐2021. For urology fellows, gastrointestinal (GI) procedures was the only index case category with a significant difference, and it was a decrease between the two COVID‐affected AYs: 2020‐2021 compared to 2019−2020 (8.9 vs. 4.2, p = 0.04). For both urology and OBGYN fellows, there was a statistically significant decrease in graft/mesh augmentation procedures from COVID‐affected AY 2019−2020 to AY 2020−2021. This may be attributed to the reclassification of mesh removal cases from graft/mesh augmentation procedures to genital procedures in 2020−2021. There was not a significant decrease in these procedures from pre‐COVID AY 2018‐2019 to the COVID‐affected AYs. There were no other statistically significant differences between AYs for OBGYN fellows.ConclusionsSurgical case volumes for FPMRS urology and OBGYN fellows who trained during the COVID‐19 pandemic were comparable to those of their pre‐pandemic peers. No significant differences between pre‐COVID and COVID‐affected years were found for either total surgical procedures or index case categories. Despite disruptions in health care nationwide, FPMRS trainee case volumes were largely unaffected.

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Retina Procedure Volume Changes during the COVID-19 Pandemic

Cited by 7 publications

References 7 publications

Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

Rehospitalization following Discharge from Newborn Nursery during Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic

Female pelvic medicine and reconstructive surgery fellows' case logs remained stable during the COVID‐19 pandemic

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