Clinical Characteristics and Learning Outcomes of Managing Orthopaedic Trauma Patients during the First Wave of Covid- 19 Pandemic: A Retrospective Cohort Analysis.

BACKGROUND

Management of trauma and emergency orthopaedic conditions during the pandemic was reorganised across the United Kingdom including our hospital following the COVID-19 British Orthopaedic Association and National Health Service England guidelines.

AIMS

This retrospective, observational cohort study analyses the impact of the first wave of COVID-19 pandemic on trauma and emergency patient care at a district general hospital. A comparative analysis to assess patient characteristics and clinical outcomes during the initial phase of COVID-19 outbreak with a cohort of patients treated during a similar period in 2019 was undertaken.

METHODS

Patients who underwent trauma and emergency surgeries between 01 April to 31 May 2020 at a Northwest Mersey NHS Trust were studied and compared to a similar period in 2019. The outcome measures assessed were 30- and 60-day mortality, Time to Surgery, length of stay after surgery, systemic and orthopaedic complications including the subsequent need for surgery.

RESULTS

Overall, there was a decrease in the number of patients who underwent trauma or emergency surgery from 184 in 2019 to 116 in 2020. 30- and 60-day mortality slightly increased by 2.05% and 2.68%, respectively. Time to surgery and hospital length of stay were comparable between both cohorts.

CONCLUSION

Continuity of services to patients with obligatory injuries was managed using enhanced personal protective equipment and infection control strategies including segregation of patients based on COVID-19 status. Lessons learnt during this period such as COVID-19 testing regime and care pathways have prepared us for the near future.

LEVEL OF STUDY

Retrospective Cohort study; Level III.