Introduction:
Given resource limitations during the Coronavirus Disease 2019 (COVID-19) pandemic and caution regarding hospital stays, surgeons tended to modify standard postoperative protocols to minimize patient exposure. Besides, there is a lack of literature focused on the impact of COVID-19 on clinical outcomes of patients. In this study, we intended to compare length of stay (LOS) and patient reported outcomes (PROs)of patients undergoing lumbar fusion surgery before and during the COVID-19 pandemic.
Methods:
We identified all patients who underwent lumbar fusion and completed 2-year-followups at a tertiary care center during two distinct time intervals: pre-COVID-19 (before March, 2020, N=132) and during COVID-19 (after March,2020, N=113). Outcome measures included LOS and PROs. PROs included visual analogue score of low back and leg pain (VAS-B and VAS-L), Oswestry disability index (ODI), and 36-item Short-Form (SF-36). Regression analyses controlled for demographic and surgical factors.
Results:
On bivariate analysis, patients undergoing surgery during the pandemic had shorter LOS (5 vs. 7 days) but reported worse mental conditions of SF-36 (32.5 vs. 36.7). After controlling for age and operation time on multivariable regression, patients who had surgery during the pandemic had shorter LOS (IRR=0.83, P<0.05) and suffered worse mental health (OR=4.5, P<0.05).
Discussion:
During the COVID-19 pandemic, LOS for patients undergoing lumbar fusion decreased. However, mental health of patients deteriorated compared to those undergoing surgery before the pandemic. More attention should be paid to psychological states of patients.