Orthopaedic Research Unit, Division of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa; Division of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa; Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
S Afr Med J. 2021 Mar 2;111(3):240-244. doi: 10.7196/SAMJ.2021.v111i3.15263.
The COVID-19 pandemic has impacted on the global surgery landscape.
To analyse and describe the initial impact of the COVID-19 pandemic on orthopaedic surgery at Groote Schuur Hospital, a tertiary academic hospital in South Africa.
The number of orthopaedic surgical cases, emergency theatre patient waiting times, and numbers of outpatient clinic visits, ward admissions, bed occupancies and total inpatient days for January - April 2019 (pre-COVID-19) were compared with the same time frame in 2020 (COVID-19). The COVID-19 timeframe included initiation of a national 'hard lockdown' from 26 March 2020, in preparation for an increasing volume of COVID-19 cases.
April 2020, the time of the imposed hard lockdown, was the most affected month, although the number of surgical cases had started to decrease slowly during the 3 preceding months. The total number of surgeries, outpatient visits and ward admissions decreased significantly during April 2020 (55.2%, 69.1% and 60.6%, respectively) compared with April 2019 (p<0.05). Trauma cases were reduced by 40% in April 2020. Overall emergency theatre patient waiting time was 30% lower for April 2020 compared with 2019.
COVID-19 and the associated lockdown has heavily impacted on both orthopaedic inpatient and outpatient services. Lockdown led to a larger reduction in the orthopaedic trauma burden than in international centres, but the overall reduction in surgeries, outpatient visits and hospital admissions was less. This lesser reduction was probably due to local factors, but also to a conscious decision to avoid total collapse of our surgical services.
COVID-19 大流行对全球外科领域产生了影响。
分析和描述 COVID-19 大流行对南非一家三级学术医院格罗特舒尔医院骨科手术的初始影响。
比较 2019 年 1 月至 4 月（COVID-19 前）与 2020 年同期（COVID-19）的骨科手术例数、急诊手术室患者等待时间以及门诊就诊、病房入院、床位占用和总住院天数。COVID-19 时间框架包括从 2020 年 3 月 26 日开始的全国“硬封锁”，以应对 COVID-19 病例数量的增加。
2020 年 4 月，即实施硬封锁的时间，是受影响最严重的一个月，尽管在之前的 3 个月中手术数量已经开始缓慢减少。与 2019 年 4 月相比，2020 年 4 月手术总数、门诊就诊和病房入院显著减少（分别减少 55.2%、69.1%和 60.6%，p<0.05）。2020 年 4 月创伤病例减少了 40%。与 2019 年相比，2020 年 4 月急诊手术室患者的整体等待时间减少了 30%。
COVID-19 及其相关封锁对骨科住院和门诊服务都产生了重大影响。封锁导致骨科创伤负担的减少大于国际中心，但手术、门诊就诊和住院人数的减少较少。这种减少较小可能是由于当地因素，但也是为了避免我们的外科服务完全崩溃而做出的有意识的决定。
