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Effect of COVID-19 on the Burden and Profile of Orthopaedic Patients Admitted Post-Resumption of Routine Services in
Sunil Kumar1, Anil K Jain1, Khan A Maroof2
1Orthopaedics, University College of Medical Sciences, New Delhi, IND.
Insights
The COVID-19 pandemic led to a 41% decrease in orthopaedic admissions. Delayed care resulted in more trauma patients experiencing complications, with half attributing issues to lockdown restrictions.
Area of Science:
- Orthopaedic Surgery
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic necessitated the suspension of routine healthcare services, including orthopaedics.
- Resumption of services post-lockdown was anticipated to reveal a backlog of patients with missed or delayed treatments and subsequent complications.
Purpose of the Study:
- To quantify the impact of the COVID-19 pandemic on the volume and characteristics of orthopaedic admissions.
- To assess the incidence of missed or delayed orthopaedic treatments and their complications post-lockdown.
Main Methods:
- A prospective study collected data on all orthopaedic admissions over one year post-lockdown in a Delhi tertiary care hospital.
- Data were compared with pre-COVID-19 data from 2017 for trauma patients and hospital records for non-traumatic conditions.
Main Results:
- Total orthopaedic admissions decreased by 41% compared to the pre-COVID-19 period.
- The proportion of trauma patients presenting with missed or complicated treatment rose from 3.1% pre-COVID-19 to 12.7% post-lockdown.
- Over half (52.5%) of these complications were attributed to COVID-19-related lockdown measures.
Conclusions:
- A significant reduction in orthopaedic patient numbers was observed after resuming routine services.
- Designating entire tertiary care hospitals for COVID-19 treatment negatively impacts timely orthopaedic care, increasing treatment complications.
Abstract:
Purpose On resumption of routine services post-lockdown during coronavirus disease 2019 (COVID-19), we expected a backlog of orthopaedic patients who could not get appropriate and timely care and would now present with complications due to missed or delayed treatment. This study aimed to quantify the effect of COVID-19 on the burden and profile of orthopaedic patients admitted post-resumption of routine services. Materials and methods Data on all the patients admitted to the orthopaedic department were collected using an interviewer-administered schedule for a complete one-year period after the resumption of routine orthopaedic services in a tertiary care hospital in Delhi. For comparison of the burden of trauma patients with that during the pre-COVID-19 period, data were obtained from a similar study done on trauma patients in 2017 at the same institution. For patients with non-traumatic conditions, previous hospital records were used. Results A total of 1585 patients were admitted during the one-year period post-resumption of routine services following COVID-19 restrictions, which was 41% less than that compared to the corresponding pre-COVID-19 data. The proportion of patients from other neighbouring states showed a decline from 52% in the pre-COVID-19 period to 41.55% when healthcare services resumed during the COVID-19 period. Out of all admitted trauma patients in 2021, 12.7% presented with a missed or complication of treatment as compared to 3.1% in the pre-COVID period. Around half of them (52.5%) attributed their complications to a COVID-19-related lockdown. Conclusion There was a significant decline in the number of patients post-resumption of routine orthopaedic care services. Converting whole tertiary care teaching hospitals to COVID-19-dedicated hospitals must not be done as it leads to an increase in missed or complication of orthopaedic treatment.
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