Elective and scheduled activities were progressively closed in the country between the 29th of February and the 16th of March. Only one centre in the south of Italy delayed the closure of the non-urgent outpatient activity to April 1.
Results are shown as follows: we give a comparison in percentage of the first week included in the study (23–29 February 2020), with the same week of 2019 (25 February–3 March 2019); then we evaluate the decrease (or increase) of the activity in percentage comparing each week of 2020 with the correspondent week of 2019. We will also show the absolute values for each week of 2020.
Outpatients clinic activity
The outpatient activity (first consultation and ordinary control) was closed in different moments in the different hospitals, according to the government and regional indications, in a period between the 29th of February and the 16th of March. Only one hospital from the south of Italy closed the activity on April 1.
During the first week, the total number of consultations showed a mean reduction of 2%, with a maximum of 15%. In the next weeks, the mean reduction became 15% in the second week, 57% in the third, 67% in the fourth, 75% in the fifth and finally 74% in the sixth week as reported in Fig. 2 on the left side, in addition to cumulative data for each week of 2020 on the right side.
First consultations increased by 7% in the first week, then the reduction was respectively 25%, 85%, 91%, 95% and 90% weekly.
Ordinary control visits showed as well a progressive reduction from 11 to 17%, 72%, 78%, 86% and 79% in the last week.
Post-operative checks were reduced by 2%, 6%, 29%, 39%, 58% and 51%, respectively.
Post-ER consultation showed a reduction of 0%, 15%, 59%, 49%, 57% and finally 67%.
Data from the hospital registry showed that the number of total ER access in the first week improved by 17%, and from the subsequent week, the activity started to decrease by 28% in the second week, 60%, 57%, 66% and 71% in the following weeks as reported in Fig. 3 on the left side, as well as the cumulative data for each week of 2020 on the right side.
In particular, the road accidents that were increased at the end of February by 43%, in the subsequent weeks reduced by 22%, and then by 68%, 87%, 94% and 77% in the last week, reflecting the lockdown imposed.
Sports injuries increased by 70% in the first week, then there was a progressive reduction of 51%, 84%, 96%, 98% up to 100% as any team or individual outdoor sports activity of individuals and teams was prohibited.
Considering work injuries, we found an increase of 60% of traumas in the first week, and a progressive weekly reduction of 30%, 73%, 55%, 63% and 72% afterwards.
Domestic injuries increased by 15% in the first week and subsequently decreased by 25%, 41%, 40%, 56% and to 41% in the last week considered.
The elective surgery was closed in all the hospitals involved in the study in a period between the 23rd of February and 14th of March.
In the first week, the mean of elective surgery decreases of 5%, 15% in the second week, 69% in the third week, 99% in the fourth and up to 100% in the last two weeks as shown in Fig. 4 on the left side, in addition to the all surgical activity data for each week of 2020 on the right side.
Concerning trauma surgery, fractures operated during the considered timeframe with the exclusion of femoral neck fractures increased by 46% in the first week and successively decreased by 9%, 12%, 39%, 51 and 50%. The trend of proximal femoral fractures was represented by an increase in the number of cases of 9% in the first week, and afterwards by a decrease of 20%, 14%, 26%, 7% and 15% for each week. Considering those operated within 48 hours, the range of variation compared with 2019 went from + 23% to − 23%, and the range of change of the ones operated after 48 hours went from + 7% to − 65%.
The two centres located in north Italy dealing also with orthopaedic oncology presented a mean reduction of the activity of 14.8% during the period considered, with a maximum of 41% in the third week.
The hospital admission due to trauma patients presented in OR decreased in comparison with 2019 of a mean value of 10.8%, with a maximum in the fifth week (− 31%). The admission related to elective surgery decreased by 34% in the first week, 21% in the second week, 91% in the third week and up to 100% in the last three weeks.