How has the COVID Pandemic Impacted the Clinical Volume and Variety of an Academic Oral and Maxillofacial Surgery Program?

Michael J Cimba; Saxon Day; Matthew J Rose; Kevin C Lee; Sung-Kiang Chuang; Helen E Giannakopoulos; Brian P Ford

doi:10.1016/j.joms.2021.06.033

How has the COVID Pandemic Impacted the Clinical Volume and Variety of an Academic Oral and Maxillofacial Surgery Program?

J Oral Maxillofac Surg. 2021 Dec;79(12):2482-2486. doi: 10.1016/j.joms.2021.06.033.

Authors

Michael J Cimba¹, Saxon Day², Matthew J Rose², Kevin C Lee³, Sung-Kiang Chuang⁴, Helen E Giannakopoulos⁵, Brian P Ford⁶

Affiliations

¹ DMD Candidate, Dental School, University of Pennsylvania School of Dental Medicine, Philadelphia, PA. Electronic address: 19104.mcimba@upenn.edu.
² DMD Candidate, Dental School, University of Pennsylvania School of Dental Medicine, Philadelphia, PA.
³ Resident, New York-Presbyterian/Columbia University, Irving Medical Center, New York, NY.
⁴ Clinical Professor, Department of Oral and Maxillofacial Surgery, University of Pennsylvania, School of Dental Medicine, Philadelphia, PA; Private Practice, Brockton Oral and Maxillofacial Surgery Inc, Brockton, MA; Attending, Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, MA; Visiting Professor, Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University, School of Dentistry, Kaohsiung, Taiwan.
⁵ Associate Professor and Program Director, Department of Oral and Maxillofacial Surgery, University of Pennsylvania School of Dental Medicine, Philadelphia, PA.
⁶ Associate Professor, Department of Oral and Maxillofacial Surgery, University of Pennsylvania School of Dental Medicine, Philadelphia, PA.

Abstract

Purpose: Attempts to mitigate the coronavirus disease of 2019 (COVID) have disrupted the delivery of non-pandemic care. The purpose of this study was to evaluate the effects of the COVID pandemic on surgical volume and variety at an academic oral and maxillofacial surgery program.

Materials and methods: A retrospective cohort study was conducted using the surgical logs of the University of Pennsylvania, Department of Oral and Maxillofacial Surgery from January 2012 through January 2021. Each record identified patient demographics and case classifications. The study predictor was timing of care, which was divided into pre-pandemic, peak pandemic, or post-peak pandemic. The primary study outcomes were the monthly procedure count and the procedure categories. The secondary dependent variables were patient age and race. Multivariate and univariate analyses of variance were used to determine whether pandemic effects existed within outcome groups.

Results: The final sample included 64,709 surgical procedures. Before, during, and after the pandemic peak, there were means of 691.0, 209.0, and 789.4 procedures per time period, respectively (P < .01). There was significantly more infection (baseline 2.2%, peak 6.0%, post-peak 2.0%, P < .01) and trauma (baseline 5.3%, peak 26.7%, post-peak 3.9%, P < .01) cases during the pandemic peak. The mean percentage of pediatric patients increased during the peak and post-peak periods (baseline 2.4%, peak 12.9%, post-peak 10.2%, P < .01). No differences were observed among the mean percentage of White (P = .12), Black (P = .21), and Hispanic (P = .25) patients treated.

Conclusions: Along with a predictable decline in surgical numbers, a greater proportion of infection and trauma procedures were performed at the pandemic's peak. Despite these changes, surgery volume normalized and case variety returned to pre-pandemic levels in the post-peak period. Our study suggests that the addition of COVID restrictions did not change the case volume or variety in the months' after the initial crisis.

MeSH terms

COVID-19*
Child
Humans
Pandemics
Retrospective Studies
SARS-CoV-2
Surgery, Oral*