Change in orthopedics and traumatology admissions during the COVID-19 pandemic at a university hospital in Turkey

Abstract

Objective: The rapidly increasing cases of coronavirus disease 2019 (COVID-19) in Turkey required the reorganization of the health system. The first response to the pandemic in our university hospital was to stop elective surgery on March 30, 2020, minimize outpatient consultations and reduce the number of patients in the wards. To determine the change in the number of patients admitted to our hospital, we examined the data during the pandemic process and compared them with the data of the previous year. Methods: The number of patients admitted to Pamukkale University Orthopedics and Traumatology Outpatient Clinic and Emergency Service for orthopedic and trauma injuries between March 1, 2020 and October 31, 2020 was documented and compared with the data of the same period in 2019. Results: During the pandemic period, the number of emergency and outpatient orthopedics and traumatology admissions decreased significantly by 15% and 42.93% respectively (p<0.001). The highest decrease in outpatient admissions was in April 2020 with 79.29%, and the highest decrease in emergency admissions was in March 2020 with 31.35%. Conclusion: In conclusion, due to fear of getting infected, curfews, and decreased human mobility, there was a dramatic decrease in the number of hospital admissions between March 1, 2020, and October 31, 2020. The COVID-19 pandemic has impacted healthcare in many ways, putting some healthcare systems under great pressure and pushing others beyond their capacity. New strategies can be determined to ensure the continuity of health services and to maximize resources.

Keywords

• COVID-19
• Trauma
• Orthopaedics
• Pandemic
• Outpatient
• Emergency

References

1. WHO Director-General’s opening remarks at the mission briefing on COVID-19 – 12 March 2020. https://www.who. int/director-general/speeches/detail/who-director-general-sopening- remarks-at-the-mission-briefing-on-covid-19—-12- march-20200. (Accessed on 02.09.2021)
2. Republic of Turkey Ministry of Health-COVID-19 Information Page. https://covid19.saglik.gov.tr/. (Accessed on 02.09.2021)
3. Moynihan R, Sanders S, Michaleff ZA, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open 2021; 11:16:e045343. doi: 10.1136/bmjopen-2020-045343.
4. Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The Impact of the COVID-19 pandemic on hospital admissions in the United States. Health Aff 2020; 39:2010-7. doi: 10.1377/hlthaff.2020.00980.
5. Turkey’s effective fight against coronavirus. https://www. iletisim.gov.tr/images/uploads/dosyalar/Kovid_Kitap_ EN.pdf. (Accessed on 02.09.2021)
6. Barten DG, Latten GHP, van Osch FHM. Reduced emergency department utilization during the early phase of the COVID-19 pandemic: viral fear or lockdown effect? Disaster Med Public Health Prep 2020; 16:33-9. doi: 10.1017/dmp.2020.303.
7. Kalem M, Kocaoğlu H, Merter A, Karaca MO, Özbek EA, Kınık HH. Effects of Covid-19 pandemic curfew on orthopedic trauma in a tertiary care hospital in Turkey. Acta Orthop Traumatol Turc 2021; 55:191-5. doi: 10.5152/j. aott.2021.20263.
8. Turgut A, Arlı H, Altundağ Ü, Hancıoğlu S, Egeli E, Kalenderer Ö. Effect of COVID-19 pandemic on the fracture demographics: Data from a tertiary care hospital in Turkey. Acta Orthop Traumatol Turc 2020; 54:355-63. doi: 10.5152/j. aott.2020.20209.

9. Luceri F, Morelli I, Accetta R, Mangiavini L, Maffulli N, Peretti GM. Italy and COVID-19: the changing patient flow in an orthopedic trauma center emergency department. J Orthop Surg Res 2020; 14:323-4. doi: 10.1186/S13018.020.01816-1.
10. Elbardesy H. Impact of the COVID-19 pandemic on trauma and orthopaedic service in the Republic of Ireland. EMJ Microbiol Infect Dis 2020:doi: 10.33590/ emjmicrobiolinfectdis/20-00116.
11. Dhillon MS, Kumar D, Saini UC, Bhayana H, Gopinathan NR, Aggarwal S. Changing pattern of orthopaedic trauma admissions during COVID-19 pandemic: experience at a tertiary trauma centre in India. Indian J Orthop 2020; 54:374. doi: 10.1007/S43465.020.00241-0.
12. Lezak BA, Cole PA Jr, Schroder LK, Cole PA. Global experience of orthopaedic trauma surgeons facing COVID-19: a survey highlighting the global orthopaedic response. Int Ortho 2020; 44:1519-29. doi: 10.1007/S00264.020.04644-4.
13. Czeisler MÉ, Marynak K, Clarke KE, et al. Delay or avoidance of medical care because of COVID-19–related concerns – United States, June 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1250-57. doi: 10.15585/mmwr.mm6936a4.
14. 65 yaş ve üstü ile kronik rahatsızlığı olanlara sokağa çıkma yasağı genelgesi. https://www.icisleri.gov.tr/65-yas-veustu- ile-kronik-rahatsizligi-olanlara-sokaga-cikma-yasagigenelgesi. (Accessed on 02.09.2020)