Dataset Information

Backlog in ophthalmic surgeries associated with the COVID-19 pandemic in Ontario 2020.

ABSTRACT:

Objective

To assess the volume of deferred ophthalmic surgeries in Ontario associated with the COVID-19 pandemic from March to December 2020 and suggest strategies and time required to clear the backlog.

Design

Cross-sectional study.

Participants

Ontarians eligible for the Ontario Health Insurance Plan in 2017-2020.

Methods

Backlog and clearance time for ophthalmic surgeries associated with the COVID-19 pandemic were estimated from time-series forecasting models and queuing theory.

Results

From March 16 to December 31, 2020, the estimated ophthalmic surgical backlog needing operating rooms was 92,150 surgeries (95% prediction interval, 71,288-112,841). Roughly 90% of the delayed surgeries were cataract surgeries, and a concerning 4% were retinal detachment surgeries. Nearly half the provincial backlog (48%; 44,542 of 92,150) was in patients from the western health region. In addition, an estimated 23,755 (95% prediction interval, 14,656-32,497) anti-vascular endothelial growth factor injections were missed. Estimated provincial clearance time was 248 weeks (95% CI, 235-260) and 128 weeks (95% CI, 121-134) if 10% and 20% of operating room surgical capacity per week were added, respectively, based on the weekly ophthalmic surgical volume in 2019.

Conclusions

Ontario data demonstrate that the magnitude of the ophthalmic surgical backlog in 2020 alone raises serious concerns for meeting the ophthalmic surgical needs of patients. As the pandemic continues, the accrued backlog size is likely to increase. Planning and actions are needed urgently to better manage the collateral impacts of the pandemic on the ophthalmic surgical backlog.

SUBMITTER: Jin YP

PROVIDER: S-EPMC9257112 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Backlog in ophthalmic surgeries associated with the COVID-19 pandemic in Ontario 2020.

Jin Ya-Ping YP Canizares Mayilee M El-Defrawy Sherif S Buys Yvonne M YM

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 20220706 6

<h4>Objective</h4>To assess the volume of deferred ophthalmic surgeries in Ontario associated with the COVID-19 pandemic from March to December 2020 and suggest strategies and time required to clear the backlog.<h4>Design</h4>Cross-sectional study.<h4>Participants</h4>Ontarians eligible for the Ontario Health Insurance Plan in 2017-2020.<h4>Methods</h4>Backlog and clearance time for ophthalmic surgeries associated with the COVID-19 pandemic were estimated from time-series forecasting models and ...[more]

PMID: 35905943

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Project description:Abstract Aim This study aimed to investigate the effect of the coronavirus disease pandemic on the number of surgeries for gastroenterological cancer cases in Japan. Methods The data recorded in the National Clinical Database of Japan between 2018 and 2020 were utilized for this study. Five specific surgeries for primary cancers and surgery for acute diffuse peritonitis were considered the primary endpoints. We divided the study period into the prepandemic and postpandemic (after April 2020) periods and examined the number of surgeries in relation to clinical factors. Results Overall, 228 860 surgeries were analyzed. Among the five primary cancer surgeries, the number of distal gastrectomies for gastric cancer decreased the most (to 81.0% of the monthly number in the prepandemic period), followed by that of low anterior resections for rectal cancer (91.4%). In contrast, the number of pancreaticoduodenectomies for pancreatic cancer increased by 7.1%, while that of surgeries for peritonitis remained stable. This trend was observed nationwide. We also noted a marked reduction in the number of distal gastrectomy (to 72.5%), low anterior resection (84.0%), and esophagectomy (88.8%) procedures for T1 tumors. The noncurative resection rate and mortalities were low despite the increased proportion of T4 tumors and older patients. Conclusion A marked reduction in surgeries for gastric and rectal cancers with early T factors may reflect prioritization of surgeries and reduction in cancer screenings. Although the quality of the surgery was maintained in terms of reduced mortalities and morbidities, the long‐term effects of this pandemic should be monitored. The number of surgeries for gastroenterological cancer across Japan declined soon after the state of emergency declared during the COVID‐19 pandemic. The remarkable decline in T1/T2 tumors is suggestive of the prioritization or loss of the opportunity for cancer screening. The rates of severe complications and mortality were not worsened by COVID‐19, even for acute diffuse peritonitis. However, the observed reduction in the cases and lack of rebound deserve further evaluation and public motivation to promote cancer screening.

Project description:BackgroundThe COVID-19 pandemic inevitably had consequences on routine surgical procedures. The objective was to quantify changes to five surgical procedures during the COVID-19 pandemic namely cataract surgery, hip and knee arthoplasties, coronary revascularization by angioplasty and definitive cardiac stimulation.Materials and methodAll hospitalizations with at least one act of each surgery between January 1, 2019, and June 30, 2021, were included from the database of all French residents' health-related expenses. Percentage changes between observed and expected numbers of hospital stays were calculated for each surgery in 2020 and the first half of 2021 with 95% Confidence Intervals. Expected numbers were calculated from the number in 2019 by applying an average annual change between 2015 and 2019. The type of intervention (primary operation or reoperation/revision) and/or the emergency status were also considered.ResultsA total of 2,153,857 hospitalizations for cataract surgery (0.6% revision), 398,213 for hip arthroplasty (10.9% revision and 26.9% in emergency), 276,607 for knee arthroplasty (8.2% revision), 471,318 for coronary angioplasty (48.7% in emergency) and 178,441 for cardiac stimulation (27.6% revision) were included. Activity was lower than expected in 2020 (cataract surgery: -21.9% [-22.5;-21.4]; hip arthroplasty: -13.4% [-14.8;-12.0]; knee arthroplasty: -24.6% [-26.1;-23.0]; coronary angioplasty: -11.2% [-12.7;-9.7]) without any catch-up in the first half of 2021 (cataract surgery: -5.0% [-5.8;-4.3]; hip arthroplasty: -9.9% [-11.6;-8.2]; knee arthroplasty: -22.0% [-24.0;-20.1]; coronary angioplasty: -12,1% [-13.9;-10.4]). Revisions and non-elective interventions also decreased but to a lesser magnitude. Cardiac stimulation activity was almost in line with expectations (-2.6% [-4.9; -0.3]/+0.6 [-2.2; +3.4]).ConclusionThis study shows that there was a marked decrease in four routine surgeries compared to expectations through to at least the first half of 2021, despite the gradual national rollout of the vaccine.

Dataset Information

Backlog in ophthalmic surgeries associated with the COVID-19 pandemic in Ontario 2020.

Objective

Design

Participants

Methods

Results

Conclusions

Publications

Backlog in ophthalmic surgeries associated with the COVID-19 pandemic in Ontario 2020.

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