Abstract
BACKGROUND: The 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 METHOD: All 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. RESULTS: A 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]). CONCLUSION: This 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.