Impact of the COVID-19 pandemic on orthopedic trauma workload in a London level 1 trauma center: the “golden month”

Figures & data

Table 1. Referrals between pre- and post-COVID

	Acute trauma referrals		Adults		Paediatric
	Pre-COVID	Post-COVID	Pre-COVID	Post-COVID	Pre-COVID	Post-COVID
	n = 162	n = 87	n = 135	n = 75	n = 27	n = 12
Demographic
Male	90	43	73	38	17	6
Female	72	43	62	37	10	6
Age ^a	47 (26)	50 (24)	54 (21)	56 (23)	9 (4)	9.5 (5.5)
ASA ^a	1 (0)	2 (1)	2 (1)	2 (1)	1 (0)	1 (0)
Injury
Upper limb	49	22	34	14	15	8
Lower limb	54	22	47	20	7	2
Hip	14	17	14	17	0	0
Pelvis	8	2	7	2	1	0
Polytrauma	18	17	18	1	0	0
Infection	15	7	12	5	3	2
Other	4	0	7	0	1	0
Mechanism of injury
Sporting	18	2	11	2	7	0
Fall	80	50	67	44	14	6
Fall from height > 1.5 m	8	9	8	8	0	1
Road traffic collision	25	13	24	12	1	1
Pathological	6	1	3	0	0	1
Other	25	12	20	9	5	3
Open injury	23	17	21	15	2	2
Trauma call	44	25	42	24	2	1
Operative requirement	76	48	66	43	10	5

^aMedian and (median absolute deviation).

ASA: American Society of Anesthesiologists.

Table 2. Operative trauma casemix between pre- and post-COVID

	Operative trauma cases only
	Pre-COVID	Post-COVID
	n = 90	n = 63
Demographic
Male	49	39
Female	41	24
Age ^a	43.5 (19)	50 (20)
ASA ^a	1 (0)	2 (1)
Injury
Upper limb	21	12
Lower limb	30	12
Hip	16	14
Pelvis	2	1
Polytrauma	17	16
Infection	2	5
Other	2	3
Mechanism of injury
Sporting	7	0
Fall	36	33
Fall from height > 1.5 m	4	6
Road traffic collision	25	15
Pathological	2	0
Other	6	9
Open injury	28	20
Trauma call	36	28
Operation
Total	91	67
MUA	4	3
External fixator	7	5
Frame	1	2
Removal of metal	2	1
Soft tissues/other	12	10
Percutaneous wiring	2	2
ORIF	34	23
Intramedullary device	16	13
Dynamic hip screw	8	4
Hemiarthroplasty	5	4
Anaesthetic method
General anaesthesi (GA)	78	46
Spinal	3	10
GA + spinal	7	5
Block	0	2
Local	2	0

^aMedian and (median absolute deviation),

ASA: American Society of Anesthesiologists,

MUA: manipulation under anaesthesia.

Table 3. Risk and Odds ratios (95% CI)

	Pre vs Post COVID		Fisher’s
	RR	OR	p-value
Acute referrals requiring admission	1.3 (1.1–1.5)	2.6 (1.4–4.7)	0.003
Acute referrals requiring surgery	1.2 (0.9–1.5)	1.4 (0.8–2.4)	0.2
Consultant-led operations	1.2 (1.0–1.4)	2.3 (1.0–5.4)	0.05
Operations requiring GA (± spinal)	0.9 (0.8–1.0)	0.2 (0.1–0.7)	0.006
Adult vs paediatric acute referrals	1.0 (0.9–1.2)	1.3 (0.6–2.6)	0.6
Trauma calls	1.0 (0.6–1.5)	1.0 (0.5–1.7)	1
Sporting injuries from acute referrals	0.2 (0.1–0.9)	0.2 (0.0–0.8)	0.01

Demographic data pre- and post-COVID for acute referrals.