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The Impact of the COVID-19 Pandemic on Case Volume and Wait Times of Elective Hand Procedures: A Retrospective Chart
Kathryn Uhlman1, Isabella Churchill2, Robert Dydynsky3
1Division of Plastic, Reconstructive, and Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Insights
The COVID-19 pandemic led to a significant decrease in elective hand surgeries, impacting the surgical backlog. Fewer procedures were performed during the pandemic compared to pre-pandemic times, affecting patient wait times.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Public Health
Background:
- The COVID-19 pandemic significantly disrupted healthcare systems globally.
- Surgical procedures, particularly elective ones, experienced cancellations and delays.
- Hand surgery services faced challenges in maintaining pre-pandemic operational levels.
Purpose of the Study:
- To compare the volume of elective hand surgeries during the COVID-19 pandemic versus a pre-pandemic period.
- To quantify the impact of the pandemic on the surgical backlog in hand surgery.
- To analyze factors influencing surgical wait times during these periods.
Main Methods:
- Retrospective analysis of patient health records from two academic institutions.
- Inclusion of elective hand surgeries for carpal tunnel syndrome (CTS), Dupuytren's disease (DD), and stenosing tenosynovitis.
- Comparison of surgical volumes and wait times between March 2018-July 2019 (pre-pandemic) and March 2020-July 2021 (pandemic).
Main Results:
- A total of 715 cases were analyzed.
- Elective hand surgeries decreased by 41.5% during the pandemic (264 procedures) compared to the pre-pandemic period (451 procedures).
- Mean wait times decreased for CTS and DD but increased for stenosing tenosynovitis; no demographic or comorbidity factors influenced wait times.
Conclusions:
- The COVID-19 pandemic resulted in a substantial reduction in the number of elective hand surgeries performed.
- This decrease in surgical volume directly contributes to an increased backlog of elective hand surgery procedures.
- Understanding this impact is crucial for healthcare resource allocation and patient management.
Abstract:
Introduction: The COVID-19 pandemic has decreased the number of surgeries performed in North America. The purpose of this study was to compare the number of elective hand surgeries performed during the pandemic to a corresponding pre-pandemic time period and to quantify the impact to the surgical backlog in hand surgery. Methods: Patient health records for individuals who underwent surgical management of carpal tunnel syndrome (CTS), Dupuytren's disease (DD) or stenosing tenosynovitis (time periods: March 11, 2018 to July 1, 2019 [pre-pandemic] and March 11, 2020 to July 1, 2021 [pandemic]) were retrieved from two academic institutions. The primary outcome was number of surgeries performed in each time period. Secondary outcomes included wait times for each time period; and variables as predictors of wait times, including a) age; b) gender; c) socioeconomic status; d) geographic location; and, e) comorbidities. Results: Seven-hundred-and-fifteen cases were included (447 CTR cases, 135 fasciotomy/subtotal palmar fasciectomy cases and 133 pulley release/tendon release cases). Two-hundred-and-sixty-four elective hand procedures were performed during the COVID-19 time period, compared to 451 in the pre-pandemic time period (n = 187 surgeries, 41.5%). Mean surgical wait times decreased for CTS and DD and increased for stenosing tenosynovitis during the pandemic compared to the corresponding pre-pandemic time period. No association or variation in wait times was found in regard to the aforementioned variables. Conclusions: During the pandemic, a decreased total number of elective hand surgeries were performed when compared to the corresponding pre-pandemic period. This contributes to a backlog of elective surgical procedures.
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