COVID-19 surgical backlogs persist: 4 things for hospital leaders to know

A new study from researchers at Massachusetts General Hospital in Boston found that even well into 2021, surgical procedure volumes had not fully recovered to pre-pandemic levels. This has contributed to ongoing backlogs that could result in more advanced disease and higher costs in the future. 

"We've seen inconsistent recovery rates in surgical procedures across subspecialities and case classes, which could mean growing morbidity and death rates going forward, along with higher costs to hospitals and the healthcare system," said Marc Succi, MD, attending radiologist at Massachusetts General and senior author of the study, published Aug. 18 in JAMA Network Open. 

Researchers analyzed changes in the volume of surgical procedures at the 1,017-bed hospital between Jan. 6, 2019, and Dec. 31, 2021. Nearly 130,000 procedures were included in the study and analyzed according to subspecialty and case class: elective, emergent, nonurgent or urgent. 

Four things to know: 

1. Overall weekly surgical procedure volumes fell nearly 45 percent from pre-COVID-19 levels during the height of the pandemic in 2020. This weekly volume decrease was seen across all subspecialties.

2. From May 2020 to January 2021, considered the post-COVID peak period, weekly surgical volumes recovered to only 85.8 percent of peak volumes pre-pandemic. 

3. Researchers found a "full recovery of nonurgent procedure volumes" from January 2021 through the end of the year, considered the post-vaccine period. Still, overall surgical procedure volumes remained much lower than pre-pandemic levels.  

4. Subspecialties that saw the greatest drop in volume during the height of the pandemic in 2020 through 2021 were cancer, cardiac, urology, orthopedic and general surgery. When analyzed by surgical class, urgent and elective procedural volumes have not made significant rebounds. 

"Hospitals need to thoughtfully and strategically consider which surgical subspecialties and classes of surgery to defer or not to defer in response to the next viral outbreak, realizing those decisions could have a profound impact on the health and survival of their patients later on," Dr. Succi said. 


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