The economic and psychological impact of cancellations of elective spinal surgeries in the COVID-19 era

Abstract

Background

The adoption of health care restrictions due to the COVID-19 pandemic led to the cancellation of elective surgical care. However, the impact on patients is unknown.

Objective

To evaluate the psychological and economic impact of the cancellation of scheduled spinal operations.

Methods

We identified 50 patients with cancelled surgeries between 16 March 2020 and 24 April 2020. Forty-nine (98%) participants were contacted, with whom the modified WES-Pi questionnaire was filled in during a telephone interview.

Results

Of the 49 respondents, 28 (57.2%) were aged <65 years. The most often reported problem (85.7%) was an ongoing limitation in basic daily activities. At least moderate sadness was experienced by 65.3% and disappointment by 73.5% of the patients. More than 80% reported concerns about the continuation and 73.5% about the progression of their symptoms. Out of 27 employees (55.1%), 63% could not work due to severe pain or movement limitation (p < .001). The inability to work was associated with anger (p = .037). The work-related impact of the cancellation was associated with stress (p < .0001) and concerns about continuing the symptoms (p = .004). Two-third of patients would undergo immediate surgery despite the current epidemic situation.

Conclusions

The cancellations of elective spinal surgeries have a serious psychological impact on patients. This together with potential economic consequences is especially evident in employees unable to work due to pain or movement disability. The information is beneficial for health management. Every effort should be made to resume planned surgical treatment if the epidemiological situation allows it.

Keywords:

• Spinal surgery
• cancellation
• COVID-19
• psychological impact
• pandemic

Acknowledgements

The authors thank Nisaharan Srikandarajah, MRCS, MBBS, PhD and Gautham Ullas, BMBS, BmedSci for their help in the formal arrangement of the text.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Ministry of Defence, Czech Republic [grant number MO 1012].