POSA401 Impact of COVID-19 on Surgical Activity: Experience from a French University Teaching Hospital

ABSTRACT

Objectives: The COVID-19 pandemic outbreak forced hospitals to postpone or cancel surgeries so staff and equipment could be reallocated to intensive care units. However, few studies have measured the impact of the pandemic on surgical activities. This study aimed at quantifying the impact of COVID-19 and lockdowns on surgical activity in a French university teaching hospital. Methods: All surgeries for the period between 01/2017 and 04/2021 were extracted. Seven specific surgeries were selected and classified as urgent (appendectomy, osteosynthesis [hip]) or non-urgent (forefoot & cataract surgery, cholecystectomy, arteriovenous fistula creation and total hip arthroplasty) based on expert opinion. We undertook time-series analyses of the weekly count of surgeries using negative binomial and Poisson regression models to measure the effect of COVID-19-related lockdowns (three lockdown periods March-May 2020, October-December 2020 and April-May 2021). The effects of all lockdown periods combined were analyzed and we controlled for seasonality and year-related factors. Results: We observed a significant decrease by -24% (p<0.01) in overall surgical activity during lockdown periods. Significant reductions were also noticed for non-urgent surgeries such as total hip arthroplasty, forefoot surgery and cataract surgery, with -38% (p<0.05), -48% (p<0.01) and -64% (p<0.001) respectively. Inversely, a significant increase in urgent osteosynthesis [hip] activity was observed (+46%;p<0.05), while a non-significant augmentation in appendectomies was noted (+24%). Conclusions: Significant decreases in activity were observed for non-urgent surgeries, suggesting those operations were postponed or cancelled so that resources could be reallocated internally. Furthermore, ambulatory surgeries such as forefoot & cataract surgeries were considerably impacted. Conversely, surgeries labelled as urgent seemed unaffected, indicating emergencies were still carried on during lockdowns. Our results highlight the impact of the COVID-19 pandemic and associated lockdowns on surgical activities, but the consequences on patient opportunity losses should also be explored.