Justin Yu, Jai Joshi, Carmen Wong, Nafis Ahmed, Amit Rao, Timmy Li, Ammar Al Rubaiay, G. Landis, Alisha R. Oropallo
{"title":"Lessons Learned: A Disruption in Care Leads to Increased Rates of Proximal Amputations.","authors":"Justin Yu, Jai Joshi, Carmen Wong, Nafis Ahmed, Amit Rao, Timmy Li, Ammar Al Rubaiay, G. Landis, Alisha R. Oropallo","doi":"10.25270/wmp.2023.1.4957","DOIUrl":null,"url":null,"abstract":"BACKGROUND\nIn March 2020, due to the COVID-19 pandemic, hospitalizations in New York state were restricted to emergency purposes. Non-COVID related cases involving lower extremity wounds were only admitted for acute infections and limb salvage. Patients with these conditions were placed at higher risk for eventual limb loss.\n\n\nPURPOSE\nTo understand the impact of COVID-19 on amputation rates.\n\n\nMETHODS\nA retrospective review of lower limb institution-wide amputations was conducted at Northwell Health from January 2020 to January 2021. The amputation rates during the COVID-19 shutdown period were compared to the pre-pandemic, post-shutdown, and reopening period.\n\n\nRESULTS\nThe pre-pandemic period had 179 amputations, of which 8.38 % were proximal. 86 amputations were performed during shutdown, with a greater proportion being proximal (25.58 %, p=0.0009). Following the shutdown period, amputations returned to baseline. The proportion of proximal amputations during post-shutdown was 18.5 % and during reopening was 12.06 %. Patients had 4.89 times higher odds of undergoing a proximal amputation during the shutdown period.\n\n\nCONCLUSIONS\nThe effect of COVID-19 on amputation rates demonstrates an increase in proximal amputation during the initial shutdown. This study suggests an indirect negative effect of COVID-19 hospital restrictions on surgeries during the initial shutdown period.","PeriodicalId":23741,"journal":{"name":"Wound management & prevention","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wound management & prevention","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.25270/wmp.2023.1.4957","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DERMATOLOGY","Score":null,"Total":0}
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Abstract
BACKGROUND
In March 2020, due to the COVID-19 pandemic, hospitalizations in New York state were restricted to emergency purposes. Non-COVID related cases involving lower extremity wounds were only admitted for acute infections and limb salvage. Patients with these conditions were placed at higher risk for eventual limb loss.
PURPOSE
To understand the impact of COVID-19 on amputation rates.
METHODS
A retrospective review of lower limb institution-wide amputations was conducted at Northwell Health from January 2020 to January 2021. The amputation rates during the COVID-19 shutdown period were compared to the pre-pandemic, post-shutdown, and reopening period.
RESULTS
The pre-pandemic period had 179 amputations, of which 8.38 % were proximal. 86 amputations were performed during shutdown, with a greater proportion being proximal (25.58 %, p=0.0009). Following the shutdown period, amputations returned to baseline. The proportion of proximal amputations during post-shutdown was 18.5 % and during reopening was 12.06 %. Patients had 4.89 times higher odds of undergoing a proximal amputation during the shutdown period.
CONCLUSIONS
The effect of COVID-19 on amputation rates demonstrates an increase in proximal amputation during the initial shutdown. This study suggests an indirect negative effect of COVID-19 hospital restrictions on surgeries during the initial shutdown period.