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Open AccessArticle

Development of Case Numbers during the COVID-19 Pandemic in a Center of Maximum-Care for Traumatology and Orthopedic Oncology

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Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
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Central Department of Medical Controlling, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
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Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
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Department of Tumor Orthopedics, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
*
Author to whom correspondence should be addressed.
Healthcare 2021, 9(1), 3; https://doi.org/10.3390/healthcare9010003
Received: 19 November 2020 / Revised: 18 December 2020 / Accepted: 18 December 2020 / Published: 22 December 2020
(This article belongs to the Special Issue COVID-19 Pandemic: Challenges Facing the Health System)
(1) Background: The COVID-19 pandemic has led to a significant change in the utilization of trauma surgery and tumor orthopedic hospital facilities. (2) Methods: In a monocentric retrospective analysis, the weekly numbers of cases requiring intra-clinical treatment in the first four months of 2020 were compared with those of 2019. Patients’ visits to the emergency department and shock room, consultation hours, work-related accidents, case numbers in the normal and intensive care units, ventilation hours, the “Simplified Acute Physiology Score/ Therapeutic Intervention Scoring System” (SAPS/TISS), the average length of stay in hospital, the number of operations and their degree of urgency, as well as deaths, were analyzed in a study based on the data from 7606 outpatient consultations in 2019 and 6755 in 2020, as well as 993 inpatient cases in 2019 and 950 in 2020. (3) Results: There was a significant reduction in the number of treatments per week in the emergency department (261 ± 29 vs. 165 ± 25; p < 0.001) with the same number of shock room treatments and fewer consultation hour contacts (226 ± 29 vs. 119 ± 65; p = 0.012). There were fewer inpatient cases (66 ± 7 vs. 42 ± 11; p = 0.001), resulting in a fall in the days of hospitalization (492 ± 63 vs. 308 ± 78; p < 0.001) and number of operations (73 ± 7 vs. 55 ± 10; p = 0.012), especially elective procedures (20 ± 3 vs. 7 ± 7; p = 0.008). The SAPS/TISS score was lower (1351 ± 1213 vs. 399 ± 281; p = 0.023). Fewer fracture treatments and septic surgeries were performed, while the number of procedures to treat orthopedic malignancies remained constant. (4) Conclusions: During the first phase of the COVID-19 pandemic, we observed a significant reduction in the number of cases treated in orthopedics. While the number of multiple-injured patients was unchanged, fewer patients presented for primary and regular care. Treatment of acute injuries and malignant tumor diseases was not at risk. There was no effect on in-house mortality. We see a potential for the recruitment of medical staff from the outpatient department, operating room, and the ward. In the event of a future second wave, our results may allow for early planning, particularly of the all-important human resources. Reorganization by hospitals and decreased patient numbers in trauma surgery can enable the reallocation of medical staff, equipment, and beds to increase capacity for COVID-19 patients. View Full-Text
Keywords: COVID-19; coronavirus; pandemic; emergency medicine; orthopedics; public health; case numbers; hospital capacity COVID-19; coronavirus; pandemic; emergency medicine; orthopedics; public health; case numbers; hospital capacity
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MDPI and ACS Style

Polan, C.; Burggraf, M.; Kauther, M.D.; Meyer, H.-L.; Rademacher, F.; Braitsch, H.; Jöckel, K.-H.; Hardes, J.; Streitbürger, A.; Dudda, M. Development of Case Numbers during the COVID-19 Pandemic in a Center of Maximum-Care for Traumatology and Orthopedic Oncology. Healthcare 2021, 9, 3. https://doi.org/10.3390/healthcare9010003

AMA Style

Polan C, Burggraf M, Kauther MD, Meyer H-L, Rademacher F, Braitsch H, Jöckel K-H, Hardes J, Streitbürger A, Dudda M. Development of Case Numbers during the COVID-19 Pandemic in a Center of Maximum-Care for Traumatology and Orthopedic Oncology. Healthcare. 2021; 9(1):3. https://doi.org/10.3390/healthcare9010003

Chicago/Turabian Style

Polan, Christina; Burggraf, Manuel; Kauther, Max D.; Meyer, Heinz-Lothar; Rademacher, Friederike; Braitsch, Henrik; Jöckel, Karl-Heinz; Hardes, Jendrik; Streitbürger, Arne; Dudda, Marcel. 2021. "Development of Case Numbers during the COVID-19 Pandemic in a Center of Maximum-Care for Traumatology and Orthopedic Oncology" Healthcare 9, no. 1: 3. https://doi.org/10.3390/healthcare9010003

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