ABSTRACT
Purpose: COVID-19 remains a global health crisis and continues to greatly impact health care systems. Our study highlights the role of interventional radiology (IR) during the initial phases of COVID-19 in a large health care system based in the Midwest. Materials and Methods: IR procedural volumes were compiled and stratified by service location from January 1, 2020 to April 30, 2020 for a large health care system in the Midwest. Seven-day rolling aggregate values were calculated and comparisons were made to diagnostic radiology (DR) imaging volumes during the same time frame. Percentage change in volume was calculated in relation to a state-mandated order to halt all nonessential medical care on March 17, 2020. IR procedures were stratified by category with interventional oncology (IO), dialysis interventions, and aspiration/drainage interventions comprising a majority of procedures. A Z-test for proportions was performed to assess for change in each following the state-mandated shutdown. Results: IR demonstrated a 34.9% decrease in total procedural volume following the shutdown of nonessential medical care, compared to a 45.4% decrease in DR volume. There was a 25.4% decrease in inpatient IR volume and a 41.0% decrease in outpatient volume, DR volume showed 22.2% and 57.3% decrease, respectively. Weekly outpatient volume analysis revealed the largest decrease in week 2 for IR at 49.3% and week 4 for DR at 67.0%. IO, dialysis and aspiration/drainage procedures comprised 29.1%, 13.8% and 20.4% of procedures prior to the state mandated shutdown and 31.7%, 16.2% and 26.3% afterwards. The proportion of IO and dialysis procedures were not statistically significant (P = 0.16 and 0.08 respectively) while aspiration/drainage procedures comprised a significantly higher proportion (P < 0.05) after the shutdown. Conclusions: IR volumes during the initial phase of COVID-19 were relatively less affected than total DR volumes. Specific attention to outpatient IR volumes demonstrates the valuable care provided following the state-mandated shutdown of nonessential procedures. There was no significant change in oncology or dialysis interventions provided with a significant increase aspiration/drainage procedures.
ABSTRACT
Purpose: COVID-19 has had a large impact on health care systems during the initial surge phase. Early state mandated guidelines limited non-essential medical care to help curb transmission, preserve medical resources, and ease the burden on health care systems. Our study evaluates the impact on interventional radiology (IR) and surgical procedural volumes following a state mandate to halt non-essential care in March 2020. Materials and Methods: Total IR volume and procedural volume for other surgical specialties, including vascular surgery, urology, general surgery, gynecology, and GI surgery were compiled for March 2020 and April 2020 for a large health care system based in the Midwest. Procedural volumes were compared to monthly baseline volumes calculated as an average of 6 months (January 2019 through April 2019 as well as January and February 2020). Percent change in volume for each specialty was calculated. Results: A total of 919 and 708 procedures were performed by IR during March and April 2020, respectively. The aforementioned specialties performed a total of 2,467 and 1,041 procedures in March and April 2020. IR demonstrated a 3.5% decrease in volume during March and 25.7% decrease in volume during April 2020. Vascular surgery, general surgery, urology, gynecology and GI surgery demonstrated 11.2%, 20.2%, 25.4%, 30.6%, 38% decrease in March and 25.7%, 47.4%, 63.3%, 68.0%, 72.9% and 78.7% reduction in volume in April 2020, respectively. Conclusions: Procedural volumes during the initial phase of the COVID-19 health crisis were decreased compared to baseline values. Analysis following a state mandated halt on all non-essential care yielded large resultant reductions in volumes for multiple specialties. IR volumes were relatively less impacted, suggesting a larger proportion of essential procedures during this time frame.