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Reduced Number of Pediatric Orthopedic Trauma Requiring Operative Treatment during COVID-19 Restrictions: A
A Raitio1, M Ahonen2, M Jääskelä3
1Department of Pediatric Surgery and Orthopedics, University of Turku, Turku University Hospital, Turku, Finland.
Insights
The COVID-19 pandemic significantly reduced pediatric fracture operations, primarily due to fewer sports and school injuries. However, emergency pediatric surgical operations for conditions like appendicitis remained stable.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Epidemiology
Background:
- The COVID-19 pandemic altered healthcare demands, impacting surgical services.
- Hypothesized decrease in pediatric fracture operations and emergency pediatric surgeries due to pandemic-related factors like avoiding hospital admissions.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on the frequency of pediatric fracture operations.
- To assess changes in emergency pediatric surgical operations during the pandemic.
Main Methods:
- Analysis of nationwide data from five tertiary pediatric surgical/trauma centers in Finland.
- Comparison of monthly operation frequencies for fractures, appendicitis, and acute scrotum (children >16 years) between March-May 2017-2019 and March-May 2020.
Main Results:
- A significant 31% decrease in trauma operations was observed during the pandemic peak (p=0.03), largely driven by a 32% reduction in lower limb trauma operations (p=0.006).
- Decreases in daycare, school, and organized sports-related injuries were noted in March and April 2020.
- Frequencies of appendectomies and scrotal explorations remained constant.
Conclusions:
- The study confirmed a substantial decrease in trauma operations during the COVID-19 pandemic's peak.
- Pediatric surgical emergencies for conditions like appendicitis and acute scrotum remained stable.
- Findings suggest potential resource reallocation in future public health crises.
Background And Aims:
The coronavirus outbreak significantly changed the need of healthcare services. We hypothesized that the COVID-19 pandemic decreased the frequency of pediatric fracture operations. We also hypothesized that the frequency of emergency pediatric surgical operations decreased as well, as a result of patient-related reasons, such as neglecting or underestimating the symptoms, to avoid hospital admission.
Materials And Methods:
Nationwide data were individually collected and analyzed in all five tertiary pediatric surgical/trauma centers in Finland. Operations related to fractures, appendicitis, and acute scrotum in children aged above 16 years between March 1 and May 31 from 2017 to 2020 were identified. The monthly frequencies of operations and type of traumas were compared between prepandemic 3 years and 2020.
Results:
Altogether, 1755 patients were identified in five tertiary hospitals who had an emergency operation during the investigation period. There was a significant decrease (31%, p = 0.03) in trauma operations. It was mostly due to reduction in lower limb trauma operations (32%, p = 0.006). Daycare, school, and organized sports-related injuries decreased significantly during the pandemic. These reductions were observed in March and in April. The frequencies of appendectomies and scrotal explorations remained constant.
Conclusion:
According to the postulation, a great decrease in the need of trauma operations was observed during the peak of COVID-19 pandemic. In the future, in case similar public restrictions are ordered, the spared resources could be deployed to other clinical areas. However, the need of pediatric surgical emergencies held stable during the COVID-19 restrictions.
