The Initial Impact of COVID-19 on the Orthopedic Trauma Surgeries in one of the Government Tertiary Hospitals in the Philippines

Background: This government tertiary hospital is the only COVID-19 referral hospital in the entire region, serving a total population of 4.7 million. This is a pioneer study in the local setting on the initial impact of the COVID-19 pandemic on orthopedic trauma services in a COVID-designated public tertiary hospital. Objective and quantifiable data on orthopedic surgical cases from the orthopedic department’s trauma service during a three-month period in 2020 was compared to a similar period in the previous pre-pandemic year (2019).

Methods: The study is descriptive, using review of records as the data collection method. It includes data gathering from patient charts and the census of orthopedic trauma surgical cases from March 2019 to May 2019 and March 2020 to May 2020. Descriptive statistics were used to present data in proportions and percentages.

Results: A total of 179 patients underwent 196 procedures during the pre-pandemic period and 72 patients underwent 91 procedures during the initial period of the pandemic. The total number of trauma surgical procedures decreased by 53.6%, with the upper and lower extremity procedures decreasing by 36.5% and 61.7%, respectively. The number of surgical patients decreased in the pandemic period by 59.8% compared to the previous year. There is a consistent decrease in all age groups.

Conclusion: COVID-19 modifications of institutional protocols, government health restrictions, and an increased emphasis on non-surgical treatment modalities in orthopedic patients has had a major impact on the orthopedic trauma service. The number of acute trauma surgical patients in the hospital dropped more than half in the early pandemic period. Cancelling and postponement of elective cases contributed to the significant drop of surgical cases. Continued need for orthopedic services should be considered when planning for staffing and resource deployment during the pandemic.

Keywords: COVID-19, Initial Impact, Orthopedic Trauma