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Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic

BACKGROUND: Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so. METHODS: We examined elective orthopaedic activity in NHS Taysi...

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Autores principales: Davies, Peter SE., Sinnerton, Robert JH., MacInnes, Alasdair, Faulkner, Alastair C., Hutchison, Peter D., Greensmith, Thomas SW., Roberts, Louise, Clift, Benedict
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676371/
https://www.ncbi.nlm.nih.gov/pubmed/33308925
http://dx.doi.org/10.1016/j.surge.2020.10.002
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author Davies, Peter SE.
Sinnerton, Robert JH.
MacInnes, Alasdair
Faulkner, Alastair C.
Hutchison, Peter D.
Greensmith, Thomas SW.
Roberts, Louise
Clift, Benedict
author_facet Davies, Peter SE.
Sinnerton, Robert JH.
MacInnes, Alasdair
Faulkner, Alastair C.
Hutchison, Peter D.
Greensmith, Thomas SW.
Roberts, Louise
Clift, Benedict
author_sort Davies, Peter SE.
collection PubMed
description BACKGROUND: Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so. METHODS: We examined elective orthopaedic activity in NHS Tayside during and immediately after the Scottish lockdown. Elective operations performed between 27 March 2020 and 10 August 2020 were included and compared with cases performed between 27 March and 10 August in both 2018 and 2019. Primary outcomes were 30-day mortality, 30-day complications, and nosocomial infection rates of COVID-19. FINDINGS: Fewer elective operations were performed in 2020 (258) compared with 2019 (1196) and 2018 (1261). The rate of nosocomial infection in the 2020 cohort was 0%. The 30-day mortality rate was 0%. Over 98% of patients agreed to undergo surgery after a detailed consenting process. INTERPRETATION: We were able to re-start a safe elective orthopaedic service in the early stages of recovery from the COVID-19 pandemic, compatible with the guidelines set by the Royal College of Surgery of England and the British Orthopaedic Association. Our findings will serve to reassure regions with sufficient resources that it is acceptable to restart elective surgery for urgent priority cases. They may provide a template for planned surgical care in the event of further pandemics.
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spelling pubmed-76763712020-11-20 Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic Davies, Peter SE. Sinnerton, Robert JH. MacInnes, Alasdair Faulkner, Alastair C. Hutchison, Peter D. Greensmith, Thomas SW. Roberts, Louise Clift, Benedict Surgeon Article BACKGROUND: Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so. METHODS: We examined elective orthopaedic activity in NHS Tayside during and immediately after the Scottish lockdown. Elective operations performed between 27 March 2020 and 10 August 2020 were included and compared with cases performed between 27 March and 10 August in both 2018 and 2019. Primary outcomes were 30-day mortality, 30-day complications, and nosocomial infection rates of COVID-19. FINDINGS: Fewer elective operations were performed in 2020 (258) compared with 2019 (1196) and 2018 (1261). The rate of nosocomial infection in the 2020 cohort was 0%. The 30-day mortality rate was 0%. Over 98% of patients agreed to undergo surgery after a detailed consenting process. INTERPRETATION: We were able to re-start a safe elective orthopaedic service in the early stages of recovery from the COVID-19 pandemic, compatible with the guidelines set by the Royal College of Surgery of England and the British Orthopaedic Association. Our findings will serve to reassure regions with sufficient resources that it is acceptable to restart elective surgery for urgent priority cases. They may provide a template for planned surgical care in the event of further pandemics. Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. 2021-10 2020-11-19 /pmc/articles/PMC7676371/ /pubmed/33308925 http://dx.doi.org/10.1016/j.surge.2020.10.002 Text en © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Davies, Peter SE.
Sinnerton, Robert JH.
MacInnes, Alasdair
Faulkner, Alastair C.
Hutchison, Peter D.
Greensmith, Thomas SW.
Roberts, Louise
Clift, Benedict
Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic
title Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic
title_full Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic
title_fullStr Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic
title_full_unstemmed Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic
title_short Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic
title_sort re-starting elective orthopaedic services in nhs tayside during the covid-19 pandemic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676371/
https://www.ncbi.nlm.nih.gov/pubmed/33308925
http://dx.doi.org/10.1016/j.surge.2020.10.002
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