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IMPACT OF THE COVID-19 PANDEMIC ON EMERGENCY UPPER LIMB SURGERIES IN A QUATERNARY HOSPITAL
Erick Yoshio Wataya1, João Pedro Teixeira Basmage1, Giuliana Olivi Tanaka1
1Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas HC-FMUSP, Instituto de Ortopedia e Traumatologia, Sao Paulo, SP, Brazil.
Insights
The COVID-19 pandemic led to a decrease in emergency upper limb surgeries, particularly for younger patients and blunt injuries. However, there was an increase in surgeries for amputations and fractures in older patients.
Area of Science:
- Orthopedics
- Trauma Surgery
- Public Health
Background:
- The COVID-19 pandemic significantly impacted global health systems, leading to increased emergency care demand.
- Changes in patient demographics and common diagnoses were observed during the pandemic.
Purpose of the Study:
- To compare the volume of emergency surgeries in the Hand and Microsurgery group before and during the COVID-19 pandemic.
- To analyze shifts in patient profiles and surgical procedures for upper limb emergencies.
Main Methods:
- Retrospective comparative study analyzing data from March 2018 to February 2022.
- Involved 272 patients undergoing emergency upper limb surgeries at a quaternary hospital (IOT-FMUSP).
- Compared surgical case numbers and types between two distinct two-year periods.
Main Results:
- A total of 272 patients were analyzed (87.50% male, mean age 39.54 ± 17 years).
- Emergency upper limb surgeries decreased from 142 (March 2018-Feb 2020) to 130 (March 2020-Feb 2022).
- Observed reductions in surgeries for patients aged 26-45 and blunt injuries; increases in surgeries for patients over 46, amputations, fractures, re-implantation, and open fracture fixation.
Conclusions:
- The COVID-19 pandemic altered the landscape of emergency hand and microsurgery.
- A notable shift occurred towards managing more complex cases like fractures and amputations, alongside a decrease in surgeries for younger individuals and blunt trauma.
Abstract:
The COVID-19 pandemic has triggered a global crisis in health systems worldwide. Emergency care services have been overloaded, and there have been different changes in the patient's profile and the most frequent diagnoses. The aim of the study was to compare the number of emergency surgeries in the Hand and Microsurgery group of the quaternary hospital (IOT-FMUSP) from March 2020 to February 2022, the pandemic period, with the previous two years, March 2018 to February 2020. Two hundred and seventy-two patients were evaluated, with a mean age of 39.54 ± 17 years (range 1 to 90 years), 12.50% (n = 34) women and 87.50% (n = 238) men. Between March 2018 and February 2020, 142 (52.21%) emergency upper limb surgeries were performed; between March 2020 and February 2022, 130 surgeries were performed (47.79%). There was a reduction in upper limb surgeries in patients between 26-45 years and blunt injury surgeries. There was also an increase in surgeries in patients over 46, amputations, fractures, re-implantation procedures, and open fracture fixation. Level of evidence III, Retrospective Comparative Study.
