Description
This VTT transcript captures a presentation by Dominic Meek on the effects of COVID-19 on elective orthopedic surgeries and trauma cases, particularly focusing on neck of femur fractures. The presentation is structured in segments, where the speaker discusses data from initial studies, specifically referencing a seminal Lancet paper that reported a reduction in elective operations during the pandemic. Meek highlights the stark 95% decrease in elective orthopedic surgeries at his institution and the implications for waiting lists, particularly emphasizing the failed standard processes during the lockdowns.
He introduces data from Scotland through the Scottish hip fracture audit, detailing changes in government strategies, such as the formation of the IMPACT group, to understand the correlation between COVID and hip fractures. The presentation reveals alarming statistics, like a 64.5% survival rate in hip fracture patients, and scrutinizes mortality rates based on age and pre-existing conditions. He argues that the high mortality rates were exacerbated by hospital-acquired COVID cases, urging a need for better patient isolation and discharge policies for hip fracture cases.
Meek discusses a retrospective study confirming the earlier findings, noting increased post-operative mortality, particularly among frail, elderly patients undergoing non-elective procedures. He reassures that elective patients presented a far lower risk for COVID transmission and mortality, emphasizing the need to continue elective surgeries for those patients in awaiting lists suffering from disabling conditions.
In closing, Meek advocates for a more balanced approach post-COVID, suggesting that while surgeons should focus on tackling the triage of neck of femur fractures effectively, it is essential to maintain the elective arthroplasty program to avoid detrimental impacts on patients' quality of life. He acknowledges the collaboration of numerous healthcare entities and the continuous need for data-driven decisions in the context of fluctuating COVID incidence.