The Impact of the COVID-19 Pandemic on the Provision of Minor Orthopaedic Trauma Procedures in Ireland
Asian Journal of Orthopaedic Research,
Page 1-11
Abstract
Background: The Covid-19 pandemic has affected healthcare systems worldwide including a reduction in the volume of non-essential procedures and treatments. This study explores the impact on the provision of minor orthopaedic trauma procedures from public hospitals in Ireland during the first wave of the Covid-19 pandemic.
Methods: Administrative data from 2018-2020 on hospital episodes with minor orthopaedic trauma procedures were obtained and grouped into six categories of index procedures. The Covid-19 pandemic was defined from 29th February 2020 when the first case was registered in Ireland until 30th September 2020. The number of admissions, percentage of day cases, and the average length of stay for inpatients were compared with similar periods in 2018 and 2019.
Results: There were 1433 (-27.0%) fewer admissions for the index procedures during the first 30 weeks of the Covid-19 pandemic than during the similar weeks of 2018 and 2019. The proportion of day cases remained largely unchanged (37.7% vs 38.1%) while the average length of stay for inpatients reduced significantly (p=0.006) from 3.1 to 2.7 days during the pandemic.
Conclusion: During the first wave of the Covid-19 pandemic, there was a substantial reduction in the volume of minor orthopaedic trauma procedures and a reduction in the average inpatient length of stay for patients with minor orthopaedic injuries.
Keywords:
- Ambulatory trauma
- day-case surgery
- management
- COVID-19
How to Cite
Moore, D. M., Gibbons, J. P., Sorensen, J., Moore, D. P., & Quinlan, J. F. (2022). The Impact of the COVID-19 Pandemic on the Provision of Minor Orthopaedic Trauma Procedures in Ireland. Asian Journal of Orthopaedic Research, 8(1), 1-11. Retrieved from https://journalajorr.com/index.php/AJORR/article/view/30216
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Epub 2020 May 16.
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Epub 2020 May 25
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DOI: 10.1308/rcsann.2019.0058
Epub 2019 Jun 3.
PMID: 31155898; PMCID: PMC6667966.
2. Colegate-Stone T, Roslee C, Shetty S, Compson J, Sinha J, Tavakkolizadeh A. Audit of trauma case load suitable for a day surgery trauma list and cost analysis. Surgeon. 2011 Oct;9(5):241-4.
DOI: 10.1016/j.surge.2010.10.008
Epub 2010 Dec 3.
PMID: 21843816.
3. Moore DM, Sheridan GA, Kelly PM, Moore DP. Day-case pelvic osteotomy for developmental dysplasia of the hip. J Child Orthop. 2020 Dec 1;14(6):508- 512.
DOI: 10.1302/1863-2548.14.200164
PMID: 33343745; PMCID: PMC7740682.
4. Kenny P, Moore DP. National Model of Care for Trauma and Orthopaedic Surgery; 2015.
Avaialble:https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/national-model-of-care-for-trauma-and-orthopaedic-surgery-2015.pdf
(Accessed 22 March 2021).
5. Baker PN, Salar O, Ollivere BJ, Forward DP, Weerasuriya N, Moppett IK, Moran CG. Evolution of the hip fracture population: Time to consider the future? A retrospective observational analysis. BMJ Open. 2014 Apr 19;4(4):e004405.
DOI: 10.1136/bmjopen-2013-004405
PMID: 24747789; PMCID: PMC3996816.
6. Staunton P, Gibbons JP, Keogh P, Curtin P, Cashman JP, O'Byrne JM. Regional trauma patterns during the COVID-19 pandemic. Surgeon. 2021 Apr;19(2):e49-e52.
7. Gibbons JP, Forman S, Keogh P, Curtin P, Kiely R, O'Leary G, et al. Crisis change management during COVID-19 in the elective orthopaedic hospital: Easing the trauma burden of acute hospitals. The Surgeon. 2021 Jun;19(3):e59-e66.
8. Dodaro CA, Grifasi C, Lo Conte D, Romagnuolo R. Advantages and disadvantages of day surgery in a department of general surgery. Ann Ital Chir. 2013 Jul-Aug;84(4):441-4.
PMID: 23103718.
9. Ghosh-Dastidar MB, Deshpande RP, Rajagopal K, Andersen D, Marrinan MT. Day surgery unit thoracic surgery: the first UK experience. Eur J Cardiothorac Surg. 2011 Jun;39(6):1047-50.
DOI: 10.1016/j.ejcts.2010.09.032
Epub 2010 Nov 1.
PMID: 21041100.
10. Appleby J. Day case surgery: A good news story for the NHS. BMJ. 2015 Jul 29;351:h4060.
DOI: 10.1136/bmj.h4060
PMID: 26223680.
11. Charalambous CP, Zipitis CS, Yarwood S, Hirst P. The development of a protocol in using day surgery for minor orthopaedic trauma patients. Ann R Coll Surg Engl. 2003 Jan;85(1):28-31.
DOI: 10.1308/003588403321001390
PMID: 12585628; PMCID: PMC1964335.
12. Trowbridge S, Wignadasan W, Davenport D, Sarker S, Hunter A, Gidwani S. Is it safe to restart elective day-case surgery? Lessons learned from upper limb ambulatory trauma during the COVID-19 pandemic. J Clin Orthop Trauma. 2020 Oct;11(Suppl 5):S700- S703.
DOI: 10.1016/j.jcot.2020.07.023
Epub 2020 Jul 25.
PMID: 32999543; PMCID: PMC7503152.
13. Mathai NJ, Venkatesan AS, Key T, Wilson C, Mohanty K. COVID-19 and orthopaedic surgery: Evolving strategies and early experience. Bone Jt Open. 2020 May 22;1(5):160-166.
DOI: 10.1302/2633-1462.15.BJO-2020-0021.R1
PMID: 33241227; PMCID: PMC7684389.
14. Oussedik S, Zagra L, Shin GY, D'Apolito R, Haddad FS. Reinstating elective orthopaedic surgery in the age of COVID-19. Bone Joint J. 2020 Jul;102-B(7):807-810.
DOI: 10.1302/0301-620X.102B7.BJJ-2020-0808
Epub 2020 May 15.
PMID: 32412313.
15. Johnson H. National Quality Assurance & Improvement System (NQAIS) Clinical; 2016.
Available:https://assets.gov.ie/11461/56a6dc64c71d4ea08254075afff96ca6.pdf
16. NHS Scotland. The Planned Care Improvement programme: Day Surgery in Scotland. Edinburgh: Scottish Executive; 2006.
17. StataCorp. 2019. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC.
18. BaseTable. BaseTable v1.12.0.
Avaialble:https://autodesk.github.io/react-base-table/
(Accessed 22 March 2021).
19. Schonauer F, Garner JP, Pereira JA, Pickford MA. Introduction of a hand trauma day surgery operating list. Ambul Surg. 2001 Jul;9(2):99-102.
DOI: 10.1016/s0966-6532(01)00105-6
PMID: 11454490.
20. Dillon CK, Chester DL, Nightingale P, Titley OG. The evolution of a hand day-surgery unit. Ann R Coll Surg Engl. 2009 Oct;91(7):559-64.
DOI: 10.1308/003588409X432338
Epub 2009 Aug 14.
PMID: 19686609; PMCID: PMC2966159.
21. Bhattacharyya M, Gerber B. Minimally-invasive surgical repair of ruptured Achilles tendon as a day case procedure with early full weight bearing. J One Day Surg. 2007;17(3):70–75.
22. Townsend R, Cox F. Standardised analgesia packs after day case orthopaedic surgery. J Perioper Pract. 2007 Jul;17(7):340-6.
23. Crawford DC, Li CS, Sprague S, Bhandari M. Clinical and Cost Implications of Inpatient Versus Outpatient Orthopedic Surgeries: A Systematic Review of the Published Literature. Orthop Rev (Pavia). 2015 Dec 30;7(4):6177.
24. Townsend R, Cox F. Standardised analgesia packs after day case orthopaedic surgery. J Perioper Pract. 2007 Jul;17(7):340-6
25. Iyengar K, Vaish A, Vaishya R. Revisiting conservative orthopaedic management of fractures during COVID-19 pandemic. J Clin Orthop Trauma. 2020 Jul-Aug;11(4):718-720.
DOI: 10.1016/j.jcot.2020.05.010
Epub 2020 May 16.
26. Hernigou J, Morel X, Callewier A, Bath O, Hernigou P. Staying home during COVID-19 decreased fractures, but trauma did not quarantine in one hundred and twelve adults and twenty eight children and the tsunami of recommendations could not lockdown twelve elective operations. Int Orthop. 2020 Aug;44(8):1473-1480.
DOI: 10.1007/s00264-020-04619-5
Epub 2020 May 25
27. Department of Health. Sláintecare Action Plan; 2019.
Avaialble:https://assets.gov.ie/22606/4e13c790cf31463491c2e878212e3c29.pdf
(Accessed 22 March 2021)
28. Beck B, Cameron P, Lowthian J, Fitzgerald M, Judson R, Gabbe BJ. Major trauma in older persons. BJS Open. 2018 Jun 23;2(5):310-318.
DOI: 10.1002/bjs5.80
PMID: 30263982; PMCID: PMC6156159.
29. Wang X, Zhou Q, He Y, Liu L, Ma X, Wei X, et al. Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China. Eur Respir J. 2020 Jun 4;55(6):2000544.
DOI: 10.1183/13993003.00544-2020
PMID: 32366488; PMCID: PMC7236818.
30. Curtis MJ, Samson G, Parmar N. Fixation of clavicle fractures: The role of day surgery? J One Day Surg. 2004;14(4): 89–90.
31. Commission on the Provision of Surgical Services. Guidelines for Day Case Surgery. London: The Royal College of Surgeons of England; 1992.
32. Hitchcock M. Day case anaesthesia: the surgical perspective. Surgery 1998;16: 141.4.
Jarrett PEM. Day case surgery: past and future growth. Surgery. 1997;15:94.7.
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