Trends in otolaryngology-head and neck surgery procedural volumes during the COVID-19 pandemic
Keywords:COVID-19, Surgical volumes, Public health
Background: The COVID-19 pandemic significantly impacted procedural volumes across all surgical specialties. This study aims to assess trends two years after the start of the pandemic and analyze the current surgical volume in Otolaryngology-Head and Neck Surgery.
Methods: The COVID-19 TriNetX database, consisting of 67 health care organizations (HCOs) was utilized to collect de-identified data patients that underwent otolaryngologic surgical procedures from February 1, 2018 to January 31, 2022. The pre-pandemic (2018 to 2019) and post-pandemic (2020 to 2021) periods were analyzed and compared for surgical volumes by season, surgical subspecialty, and procedure type. Student's t-test was utilized to test for statistical significance of trends between seasonal averages pre- and post-pandemic.
Results: A total of 2,005,796 otolaryngology surgical procedures from 45 HCOs were included. When comparing the average monthly post-pandemic (2020 and 2021) volumes to their pre-pandemic (2018 and 2019) seasonal counterparts, there were statistically significant decreases in the averages of all seasons. Post-pandemic seasonal volumes assessed by individual years depicted a significant decline in the total otolaryngology surgical volumes in all seasons, with the steepest reduction from Winter 2019 to Spring 2020.
Conclusions: Specialties that experienced significant reductions in volume without sufficient evidence of rebounding trends include paediatric otolaryngology and otology, while general/rhinology/endoscopy, laryngology, head and neck surgery, and facial plastics and reconstructive surgery are trending towards pre-pandemic baselines.
Saraswathula A, Gourin CG, Stewart CM. National Trends in US Otolaryngology Surgical Volume during the Early COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg. 2021;147(4):397-9.
Mehrabian D, Liu IZ, Pakhchanian HH, Tarawneh OH, Raiker R, Boyd CJ. Nationwide analysis of plastic and reconstructive procedural volume in the United States during the COVID-19 pandemic. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2022;75(4):1483-96.
Centers for Medicare and Medicaid Services. Non-Emergent, Elective Medical Services, and Treatment Recommendations; 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/ healthcare-facilities/index.html. Accessed on 20 September 2022.
American College of Surgeons. COVID 19: Elective Case Triage Guidelines for Surgical Care.; 2020. Available at: https://www.facs.org/media/augjopp0 /guidance_for_triage_of_nonemergent_surgical_procedures_otolaryngology.pdf. Accessed 5 July 2022.
American Academy of Otolaryngology - Head and Neck Surgery. Guidance for Return to Practice for Otolaryngology-Head and Neck Surgery.; 2020. Available at: https://www.cdc.gov/coronavirus/ 2019-ncov/hcp/ppe-strategy/burn-calculator.html. Accessed 5 July 2022.
Piccirillo JF. Otolaryngology-Head and Neck Surgery and COVID-19. The Journal of the American Medical Association. 2020;324(12):1145-6.
Mick P, Murphy R. Aerosol-generating otolaryngology procedures and the need for enhanced PPE during the COVID-19 pandemic: A literature review. Journal of Otolaryngology - Head and Neck Surgery. 2020;49(1).
Mattingly AS, Rose L, Eddington HS. Trends in US Surgical Procedures and Health Care System Response to Policies Curtailing Elective Surgical Operations during the COVID-19 Pandemic. JAMA Netw Open. 2021;4(12).
TriNetX LLC. TriNetX. Available at: https://trinetx. com/. Accessed on 20 September 2022.
ACGME Review Committee for Otolaryngology - Head and Neck Surgery. Otolaryngology Case Log Coding Guidelines. Available at: https://www. acgme.org/specialties/otolaryngology---head-and-neck-surgery/documents-and-resources/. Accessed on 20 September 2022.
Adedeji TO, Sogebi OA, Tobih JE. Pattern of Otorhinolaryngological Admissions via Emergency Unit in a Suburban Tertiary Center. Int J Biomed Sci. 2015;11(3):146-51.
Crosby DL, Sharma A. Insights on Otolaryngology Residency Training during the COVID-19 Pandemic. Otolaryngology - Head and Neck Surgery (United States). 2020;163(1):38-41.
Raj A, Wadhwa V, Jain A. Epidemiological Profile of ENT Emergencies: Our Experience. Indian Journal of Otolaryngology and Head and Neck Surgery. 2019;71:301-4.
Wilson AM, Sleeth DK, Schaefer C, Jones RM. Transmission of Respiratory Viral Diseases to Health Care Workers: COVID-19 as an Example. Annu Rev Public Health. 2022;43:311-30.
Cheng X, Liu J, Li N. Otolaryngology Providers Must Be Alert for Patients with Mild and Asymptomatic COVID-19. Otolaryngology-Head and Neck Surgery (United States). 2020;162(6):809-10.
Zimmermann P, Curtis N. Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections. Arch Dis Child. 2021;106(5):429-39.
Bann DV, Patel VA, Saadi R. Best Practice Recommendations for Pediatric Otolaryngology during the COVID-19 Pandemic. Otolaryngology - Head and Neck Surgery (United States). 2020;162(6):783-94.
Pizzuto MP, Volk MS, Kingston LM. Common Topics in Pediatric Otolaryngology. Pediatr Clin North Am. 1998;45(4):973-91.
Lessler J, Grabowski MK, Grantz KH. Household COVID-19 risk and in-person schooling. Science (1979). 2021;372(6546):1092-7.
D’Amore J, Meigher S, Patterson E. Intubation outcomes and practice trends during the initial New York SARS‐COV‐19 surge at an academic, level 1 trauma, urban emergency department. J Am Coll Emerg Physicians Open. 2021;2(6).
Luo M, Cao S, Wei L. Intubation, mortality, and risk factors in critically ill Covid-19 patients: A pilot study. J Clin Anesth. 2020;67.