So we have no disclosures relevant to this presentation. As we all know, the COVID pandemic introduced tremendous stress into our healthcare system. Early on, especially, there was a real push for conservation of resources. And as a result of that, elective surgeries across the country were canceled as early as March 15th in Massachusetts, which is our home state. Obviously, a significant backlog of cases to be done, stressful for all of us as surgeons. But anecdotally, this was a really hard time for the young patients we see at Boston Children's. And so if we try to put ourselves in our patients' shoes a little bit, you know, number one, they're coming to you because they hurt themselves. We tell them they need surgery. They're out of sports for some amount of time depending on their injury. And now we're telling them that we don't know when your surgery is going to be or how long you're going to be out for. So this is a really big hit for a young athlete, potentially at a really important stage of their athletic career. So the purpose of our study was to evaluate the physical and psychological consequences of elective surgery delays on young sports medicine patients. It was a cross-sectional survey study of patients 10 to 25 years old, all of whom had surgical delays due to the COVID crisis. We administered electronic surveys and selected two validated health measures, including the SF-12, which gives both a physical component score as well as a mental component score, and also the PROMIS psychological stress experience survey. We also self-designed a questionnaire to look at specific COVID-related concerns and concerns around surgical delays. It's important to note that the scoring for the validated measures, each of these scales has a population norm set to 50, and a higher score on the SF-12 indicates better health, whereas a higher score on the PROMIS PSE indicates more psychological symptoms, so worse psychological state. This is just a screenshot of some of the questions that we asked on our self-designed survey, the point of which was to assess demographics, a history of mental health conditions. We also asked patients to attribute their symptoms to either their injured body part or they were nervous about COVID or something else, and we also asked about specific concerns related to their surgery being delayed. We had 107 patients elect to participate, which was a 55% response rate. Mean age was 17.6, slightly more female than male. A significant proportion of our young patients reported a history of a mental health condition, so 24%, and 15% were actively seeing a therapist at the time of the survey. Most of our patients were awaiting lower extremity surgery, primarily the knee, and of those patients who had an originally scheduled date for surgery that was canceled, the average time to survey completion from that surgical date was 44 days, and the average time to surgery was 76 days. When we look at our survey outcomes, we found that our patients scored significantly differently from population norms on two of the measures, so the SF physical component scale was lower than the general population, which we would expect with an extremity injury, but we also found that they had statistically significant higher scores on the PROMIS psychological stress experience survey compared to the general population. We did not find any differences in the mental component score overall, however, there were some differences in the way males and females reported this. In terms of general concern for delay of surgery, this was, on average, rated as a four out of five, which corresponded to very concerned, and these are our stratified outcomes. Some of the key takeaways from this busy slide are that the patients that reported more concern with their surgical delay tended to report more symptoms, both physical symptoms as well as psychological symptoms, on both the mental component score and the PROMIS PSE. We also found that our patients with a history of mental health conditions reported higher emotional symptoms on both the SF-12 mental component score and the PROMIS score. We also asked the patients, what's your biggest concern with the fact that your surgery is delayed? And the most common response was concerns about potentially not being back in time for a sport season, and that was particularly prevalent among our pre-adolescent and our adolescent patients. There are certainly limitations to this type of studies, but I think it's important to ask how our patients are doing. The biggest limitation is probably that we don't have baseline data of what patients normally experience while they're waiting for surgery, and now that things are back up and running, this might be something we look at in the future. So, our conclusions were that young sports medicine patients reported significant physical and emotional symptoms associated with their surgical delays. Patients were most concerned about delays resulting in missed sport seasons, and those patients who reported greater levels of concern with surgical delays endorsed more emotional symptoms and higher levels of psychological stress. Thanks so much.

elective surgery delays

young sports medicine patients

COVID-19 pandemic

physical and psychological consequences

surgical delays