The effect of COVID-19 pandemic on routine surgical turnover in otolaryngology: a retrospective analysis of service dynamics utilizing finalized, cumulative data from a tertiary-care teaching institute in India.

Abstract

Objective: To ascertain the effect of coronavirus (COVID-19) pandemic on routine (non-COVID) Otolaryngology and Head-Neck Surgery (ORL-HNS) turnover in a tertiary-care teaching institute, utilizing the cumulated, finalized dataset one year after the pandemic ceased to be a "public health emergency of international concern".

Methodology: In this retrospective analysis, annual routine turnover in the ORL-HNS categories (otology, rhinology/skull-base, head-neck/airway, emergency, miscellaneous) for the COVID-period (2020-21) were individually compared with pre-COVID (2017-19) data. Subsequently, categorical turnovers, along with the major surgeries in each category, were compared trimester-wise in the COVID-period. Data were interpreted statistically and explained graphically superimposing on the COVID timeline.

Results: Overall surgical turnover in 2020-2021 decreased by 64.11% and 34.59%, respectively, from the pre-COVID period. The decline was [62.3%, 78.05%, 59.96%, 65.14%] and [34.2%, 29.27%, 30.64%, 45.6%] in otology, rhinology/skull-base, head-neck/airway, and emergency surgeries, in 2020 and 2021, respectively. Significant decline, however, was only in rhinology/skull-base (p = 0.00012) for 2020, which again increased in 2021 (p < 0.00001). Tympanomastoid surgeries, endoscopic sinus/septal surgeries, direct laryngoscopic procedures and tracheostomy topped the respective categories. Despite the deadlier second wave in 2021, there was a statistically significant change in trimester-wise turnovers across categories from 2020 to 2021. Overall turnover in 2020 was lesser, the second and third (lockdown/unlock) trimesters being mostly affected.

Conclusions: In the most comprehensive post-COVID service dynamics analysis, routine ORL-HNS turnover was apparently not found to be significantly affected by the pandemic except in rhinology/skull-base. However, trimester-wise comparison within the COVID-years revealed statistically significant changes in categorical turnovers from 2020 to 2021.