Covid-19 and maxillo-facial fractures: A comprehensive retrospective cohort study on the analysis of costs in COVID-19 era
Keywords:Maxillo-Facial fractures, COVID-19, Closed fractures, Medical costs, Multiple fractures, Cost analysis
Background/Aim: Maxillofacial trauma management has also undergone a change starting from December 2019 due to the emergence of a new viral infection, later called COVID-19, and then a pandemic mandating new medical protocols. This retrospective cohort study aimed to explain the changes in medical costs and underlying causes of cases with maxillofacial bone fractures during the COVID-19 period, based on the lack of focus on cost analyses on this subject in previous studies. Methods: Patients who were operated on for maxillofacial trauma in our clinic before and during the COVID-19 outbreak were retrospectively analyzed in terms of sex, age, etiology, personal protective equipment (PPE) usage, treatment methods, and total costs. Statistical analyses were carried out for any significant changes. Results: A total of 78 patients of which 38 were operated on before whereas 40 were operated on during the COVID-19 outbreak, were included in this study. Accordingly, 24 patients of the pre-COVID-19 group and 37 patients of the post-COVID-19 group were admitted from Emergency Department (ED), which included all the first wave patients (n=21). In the pre-COVID-19 group, a total of 220 screws and 58 plates were used for 22 IRFs. The total LoH of the patients was 180 days. In the post-COVID-19 group, 274 screws and 70 plates were used for 24 IRFs. The total LoH of the patients was 185 days. A total of 156 PPE including N95 masks and extra operation shirts were used. The pre-COVID-19 group’s treatment costs were calculated as USD 320.3 per patient. Post-COVID-19 group’s treatment costs were calculated as USD 496.68 per patient. Conclusion: The statistical evaluations revealed that the COVID-19 pandemic resulted in differences due to the introduction of PCR tests applied for each patient and the PPE used for the precautions taken for the COVID-19 infections. On the other hand, there were no changes in the number of the use of plates, screws, and in the length of hospitalization. It can be argued that this outcome has led to no necessary changes in the treatment protocols in terms of costs.
Riva FM, Kerawala C. Maxillofacial services in the COVID-19 (SARS-CoV-2) pandemic–early lessons from the Italian experience. The British Journal of Oral & Maxillofacial Surg. 2020 Sep 58;(7):744-5.
Sawhney C, Singh Y, Jain K, Sawhney R, Trikha A. Trauma care and COVID-19 pandemic. Journal of Anaesthesiology, Clinical Pharmacol. 2020 Aug 36;(1):115-20.
Dash S, Das R, Saha S, Singhal M. Plastic Surgeons and COVID-19 Pandemic. Indian Journal of Plastic Surg. 2020 Aug 53;(02):191-7.
Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research met. 2007 May;39(2):175-91.
Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior research methods. 2009 Nov; 41(4):1149-60.
Zimmermann M, Nkenke E. Approaches to the management of patients in oral and maxillofacial surgery during COVID-19 pandemic. Journal of Cranio-Maxillofacial Surg. 2020 May 1;48(5):521-6.
Kaye AD, Okeagu CN, Pham AD, Silva RA, Hurley JJ, Arron BL, Sarfraz N, Lee HN, Ghali GE, Gamble JW, Liu H. Economic impact of COVID-19 pandemic on healthcare facilities and systems: International perspectives. Best Practice & Research Clinical Anaesth. 2021 Oct 1;35(3):293-306.
Altiparmak M, Pektas ML, Kasap S, Tosun K, Nisanci M. Cost-based analysis of operative maxillofacial fracture managements. Turkish Journal of Plastic Surg. 2020 Apr 1;28(2):104-10.
Sanger C, Argenta LC, David LR. Cost-effective management of isolated facial fractures. Journal of Craniofacial Surg. 2004 Jul 1;15(4):636-41.
Brar B, Bayoumy M, Salama A, Henry A, Chigurupati R. A survey assessing the early effects of COVID-19 pandemic on oral and maxillofacial surgery training programs. Oral surgery, oral medicine, oral pathology and oral rad. 2021 Jan 1;131(1):27-42.
Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endo. 2006 Jul 1;102(1):28-34.
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