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Delbrück H, Lambertz E, Migliorini F, Berger N, Hildebrand F. Influence of COVID-19 pandemic on hospitalisations at a paediatric traumatology department during 2020: a single-centre observational study and comprehensive literature review. Eur J Trauma Emerg Surg 2024; 50:591-601. [PMID: 38286949 PMCID: PMC11035450 DOI: 10.1007/s00068-024-02453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/14/2024] [Indexed: 01/31/2024]
Abstract
PURPOSE The study investigates changes in the injury characteristics of hospitalised children in a paediatric trauma centre during the COVID-19 pandemic. METHODS Data from injured children from the pre-pandemic year 2019 were compared to the pandemic year 2020 using Pearson's chi-squared test and the Mann-Whitney U test. The period of highly restrictive regulations (HRP) was evaluated separately. A comprehensive literature review with defined search terms resulted in a descriptive data synthesis. RESULTS Data from 865 patients indicated reductions in admissions of 5.6% and 54.4% during the HRP. In 2020, the hospitalisation time was longer (2.2 ± 2.7 days in 2019 vs. 2.4 ± 2.6 in 2020, p = 0.045); the proportions of wounds requiring surgical therapy (p = 0.008) and of observational treatments, primarily for mild brain injuries (p = 0.046), were higher; and conservative treatments, primarily for contusions, were lower (p = 0.005). There were no significant changes in age, location of lesions, or frequency of surgical therapy; nor were there differences in the HRP, except for fewer injuries in school and kindergarten (p < 0.001). The literature review summarises the main results of 79 studies. CONCLUSION Limited resources did not alter the indications for surgical therapy. Further studies should examine whether the more common injuries sustained at home were caused by excessive work/childcare demands on parents. Reduced inpatient conservative treatment implies that hospital resources possibly were overused previously. The literature offers answers to many detailed questions regarding childhood injuries during a pandemic and more efficient safe treatment. Registration Ethical committee of RWTH Aachen University EK 22-320; Center for Translational & Clinical Research RWTH Aachen University (CTC-A) 21-430.
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Affiliation(s)
- Heide Delbrück
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Ellen Lambertz
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
- Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy
| | - Nina Berger
- Department of Neuromuscular and Paediatric Orthopaedics, Klinikum Dritter Orden München - Nymphenburg, Menzinger Strasse 44, 80638, München, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
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Hsu CH, Huang HT, Chen CH, Fu YC, Chou PH, Hsu NC. Global Impact of the COVID-19 Pandemic on Orthopedics and the Implications of Telemedicine: A Systematic Review of the Literature. J Clin Med 2022; 11:jcm11112983. [PMID: 35683371 PMCID: PMC9181233 DOI: 10.3390/jcm11112983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/16/2022] [Accepted: 05/21/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to systematically review the literature on the impact of the coronavirus disease (COVID-19) pandemic on the orthopedics field by focusing on multiple aspects, including orthopedic training and application, performance, work loading, change of practice, research work, and other psychological factors. Published articles were searched using the PubMed database. Articles were selected in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 58 studies published between 1 January 2020 and 1 October 2021, 57 peer-reviewed original articles were included. Nearly 90% of students experienced an impact of the pandemic on application. The impact on training stemmed from redeployment rates of 20.9–23.1%. The rate of emergency or outpatient visits decreased from 18% to 58.6%. The rates of all surgeries or emergency surgeries decreased by 15.6–49.4%, while the rates of elective surgeries decreased by 43.5–100%. The rate of work loading ranged from 33% to 66%. Approximately 50–100% of surgeons had a change of practice. A total of 40.5% of orthopedic surgeons experienced mild psychological pressure. Approximately 64% had stopped research participant recruitment. Most of the included studies were conducted in Europe, followed by Asia and North America. It is suggested orthopedic surgeons prepare more sufficient, flexible, and reservable staffing measures, proper preventive strategies and surgical scheduling algorithms, and set up dedicated venues and equipment for routine telemedicine with staff training for virtual teaching or consultations in case of future impacts on orthopedics.
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Affiliation(s)
- Chia-Hao Hsu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Hsuan-Ti Huang
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Chung-Hwan Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Yin-Chih Fu
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Pei-Hsi Chou
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Nin-Chieh Hsu
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei 10002, Taiwan
- Correspondence: ; Tel.: +886-2-23123456 (ext. 65130)
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