Decreases in Elective and Non-Elective Surgical Case Volumes During the COVID-19 Pandemic

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on surgical healthcare delivery systems. Multiple surgical organizations outlined recommendations on the performance of surgeries to minimize viral transmission, prioritize resource allocation, and avoid perioperative complications. This study aims to characterize the changes in surgical volume during the COVID-19 pandemic.

Methods: A retrospective chart review was performed at a large public hospital to characterize the surgical case volume, specialties performing surgeries, case urgency (elective vs. non-elective), patient presentation (emergency room, clinic, inpatient), and patient demographics. Data were collected between January 17 and May 8, 2020, 8 weeks prior to and 8 weeks after the declaration of COVID-19 as a national emergency in the USA. For comparison, data between January 17 and May 8, 2019 were also collected. A univariate analysis was performed via paired tests between the two years.

Results: There was a statistically significant decrease in both elective and non-elective cases in 2020. When compared to 2019, the weekly case volume in 2020 is significantly higher prior to the declaration of COVID-19 a national emergency (weeks 1 - 8) and significantly lower after the declaration of COVID-19 as a national emergency (weeks 9 - 16). Additionally, there appeared to be statistically significant decrease in non-elective surgical case volumes.

Conclusions: In facing the challenges presented by the COVID-19 pandemic, clinician leaders have been tasked with making difficult decisions regarding patient care. While leading surgical organizations provided guidelines for best practices at the start of the pandemic, the long-term implications of these decisions are unknown. This study has found that the COVD-19 pandemic has resulted in decreased volume of both elective and non-elective surgeries, raising concerns that necessary care may be delayed for marginalized populations.

J Curr Surg. 2021;11(4):73-81
doi: https://doi.org/10.14740/jcs452