The impact of the post- COVID 19 pandemic elective waiting list delays on patient reported symptoms and intention to proceed with planned upper limb surgeries-A prospective cohort study.

Abstract

The aim of this study was to evaluate patient reported outcome measures using the EQ5D-5L and EQ5D-5L visual analogue scale (VAS) following elective shoulder and elbow orthopaedic list delays. This was further correlated with patients' intention to proceed with the planned surgery. Patients on the waiting list for more than 26weeks were included in the study. Telephone interviews were conducted utilising the EQ5D-5L and the EQ5D-5L VAS at the time of addition to the waiting list and presently. 75 out of 324 screened patients were eligible. 62 (82.7%) patients still wanted to proceed with their planned procedure while 13 (17.3%) patients in the other group no longer wanted to proceed. There was no statistically significant difference in the mean age, gender, initial trial of conservative treatment and limb laterality between these groups (p<0.05). There was a statistically significant difference in the mean duration of being on the waiting list between these groups (40.4±19 vs. 62.9±17.5weeks respectively). Furthermore, statistically significant differences (p<0.05) in the current EQ5D-5L VAS scores were observed between these groups (52.4 vs. 65.8 respectively). This study has shown that majority of patients on elective shoulder and elbow orthopaedic lists with prolonged waiting list delays and improved EQ5D-5L scores are likely to decline the planned procedure and vice versa. Nevertheless, the unplanned 'watchful waiting' caused by the COVID-19 pandemic and leading to patients deciding to decline surgery, is not a substitute for timely planned surgery to alleviate patients' suffering.