Impact of COVID-19 Pandemic on Orthopaedic Practice

Study Overview
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Brief Summary
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The COVERT Collaborative is led by a group of academic surgeons that is looking into the impact of the unprecedented COVID-19 pandemic on Trauma and Orthopaedic practice. This will involve both trauma and elective procedures, as well as mortality rates, operative and anaesthetic case mix. The information will help to shape service reconfiguration and enhance patient-specific treatment especially in the threat of potential subsequent waves and future pandemics.

Detailed Description
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In response to the health crisis, it is the responsibility of clinicians to audit and collaborate in order to observe the impact of the pandemic on clinical practice. With the restructure of the health infrastructure, there is likely to be changes to the nature of acute referrals to Trauma and Orthopaedics, operative and anaesthetic casemix, polytrauma and open fractures as well as the role of technology to reduce viral transmission. Patient safety ought to be prioritised at all times but a national narrative is required to equip healthcare services to counter the pandemic at various time intervals post-social distancing and lockdown at 1.5, 3, 6, 12, 18 and 24 months. This will act as an audit to compare and contrast if the reconfiguration of healthcare services is abiding by the governmental, DoH, NHS, WHO, RCS and BOA (BOAST) policies and guidelines.

Official Title
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Impact of COVID-19 Pandemic on Orthopaedic Practice: the COVid-19 Emergency/Elective Related Trauma (COVERT) Collaborative

Conditions
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Covid19, Trauma, Orthopedic Disorder, Anesthesia, Morality

Intervention / Treatment
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* Other: type of treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: anyone presenting with orthopaedic trauma to the Emergency Department who has been referred to the on-call Trauma and Orthopaedic team for further management. Exclusion Criteria: spinal trauma
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intra-COVID lockdown<br>Any patients treated for orthopaedic trauma within the mandatory lockdown due to the pandemic. | Other: type of treatment<br>* pathway of management for conservative treatment, operative treatment and type of anaesthesia used<br>|
| Pre/post-COVID lockdown<br>Any patients treated for orthopaedic trauma either before or after the imposition of lockdown induced by the pandemic. | Other: type of treatment<br>* pathway of management for conservative treatment, operative treatment and type of anaesthesia used<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Treatment | Non-operative vs operative management | duration of study | 
| Mortality rate | For patients presenting with orthopaedic trauma | duration of study | 
| Number of COVID positive patients | For patients presenting with orthopaedic trauma regardless of treatment pathway | duration of study |