Dataset Information

Resilience Against COVID-19: How Italy Faced the Pandemic in Pediatric Orthopedics and Traumatology.

ABSTRACT:

Background

We aimed to investigate the variation of medical and surgical activities in pediatric orthopedics in Italy, during the year of the COVID-19 pandemic, in comparison with data from the previous two years. The differences among the first wave, phase 2 and second wave were also analyzed.

Methods

We conducted a retrospective multicenter study regarding the clinical and surgical activities in pediatric orthopedics during the pandemic and pre-pandemic period. The hospital databases of seven tertiary referral centers for pediatric orthopedics and traumatology were queried for events regarding pediatric orthopedic patients from 1 March 2018 to 28 February 2021. Surgical procedures were classified according to the "SITOP Priority Panel". An additional classification in "high-priority" and "low-priority" surgery was also applied.

Results

Overall, in 2020, we observed a significant drop in surgical volumes compared to the previous two years. The decrease was different across the different classes of priority, with "high-priority" surgery being less influenced. The decrease in emergency department visits was almost three-fold greater than the decrease in trauma surgery. During the second wave, a lower decline in surgical interventions and a noticeable resumption of "low-priority" surgery and outpatient visits were observed.

Conclusion

Our study represents the first nationwide survey quantifying the impact of the COVID-19 pandemic on pediatric orthopedics and traumatology during the first and second wave.

SUBMITTER: Trisolino G

PROVIDER: S-EPMC8305147 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundPrevention of hospital-acquired infections, in the clinical field of orthopedics and traumatology especially surgical site infections, is one of the major concerns of patients and physicians alike. Many studies have been conducted proving effective infection prevention measures. The clinical setting, however, requires strategies to transform this knowledge into practice.Question/purposeAs part of the HYGArzt-Project ("Proof Of Effectivity And Efficiency Of Implementation Of Infection Prevention (IP) Measures By The Physician Responsible For Infection Prevention Matters In Traumatology/Orthopedics"), the objective of this study was to identify effective implementation strategies for IP (infection prevention) measures in orthopedics and trauma surgery.MethodsThe systematic review was conducted following PRISMA guidelines. A review protocol was drafted prior to the literature search (not registered). Literature search was performed in MEDLINE, SCOPUS and COCHRANE between January 01, 1950 and June 01, 2019. We searched for all papers dealing with infection and infection control measures in orthopedics and traumatology, which were then scanned for implementation contents. All study designs were considered eligible. Exclusion criteria were language other than English or German and insufficient reporting of implementation methods. Analyzed outcome parameters were study design, patient cohort, infection prevention measure, implementation methods, involved personnel, reported outcome of the studies and study period.ResultsThe literature search resulted in 8414 citations. 13 records were eligible for analysis (all published between 2001 and 2019). Studies were primarily prospective cohort studies featuring various designs and including single IP measures to multi-measure IP bundles. Described methods of implementation were heterogeneous. Main outcome parameters were increase of adherence (iA) to infection prevention (IP) measures or decrease in surgical site infection rate (dSSI%). Positive results were reported in 11 out of 13 studies. Successful implementation methods were building of a multidisciplinary team (considered in 8 out of 11 successful studies [concerning dSSI% in 5 studies, concerning iA in five studies]), standardization of guidelines (considered in 10/11 successful studies [concerning dSSI% in 5 studies, concerning iA in seven studies]), printed or electronic information material (for patient and/or staff; considered in 9/11 successful studies [concerning dSSI% 4/4, concerning iA 5/5]), audits and regular meetings, personal training and other interactive measures as well as regular feedback (considered in 7/11 successful studies each). Personnel most frequently involved were physicians (of those, most frequently surgeons) and nursing professions.ConclusionAlthough evidence was scarce and quality-inconsistent, we found that adhering to a set of implementation methods focusing on interdisciplinary and interactive /interpersonal work might be an advisable strategy when planning IP improvement interventions in orthopedics and traumatology.