Endocrine Abstracts

Background: The COVID-19 pandemic has resulted in widespread disruption to delivery of emergency and elective care in the last 2 years. Nevertheless, healthcare systems have quickly readapted to accelerate use of novel pathways for delivering clinical services. We reviewed the impact of COVID-19 pandemic on our time from community referral to definitive surgery in patients with Primary Hyperparathyroidism (PHPT).

Methods: We retrospectively reviewed the waiting times from General Practice (GP) referral to parathyroid surgery through our pathway which includes initial Endocrinology review before referral for surgical review. Data was collected before COVID19 pandemic (2019) and compared with data during the pandemic (2020–2021). Results are reported as mean for continuous variables. The Mann Whitney U test was used for comparing continuous variables between groups. A P value of <0.05 was considered statistically significant.

Results: 28 patients were included in the pandemic cohort and 37 patients were in the pre-pandemic cohort. Time from GP referral to Endocrinology review was 60 days in the pandemic cohort (vs. 91 days in the pre-pandemic cohort, P=0.03). Time from first Endocrinology review to referral for surgery was 26 days in the pandemic cohort, compared to 341 days in the pre-pandemic cohort (P <0.01). There was no statistical difference in waiting times from surgical referral to surgical clinic review and thence to surgery between the pandemic and pre-pandemic cohort (54 days vs. 73 days and 181 days vs. 156 days, respectively). Overall, time from GP referral to definitive surgery was lower in the pandemic cohort at 314 days compared to 651 days in the pre-pandemic cohort (P<0.01), with the most impact on this reduced waiting time being from GP referral to surgical referral by Endocrinology (84 days vs. 422 days, P<0.01). There was no difference in our surgical pathway from time of referral for surgery to date of surgery in both cohorts (239 days v.s 229 days, P=0.85).

Conclusion: Our waiting times from GP referral to definitive surgery in patients with PHPT are surprisingly lower during the COVID-19 pandemic when compared to pre-pandemic times. These improved waiting times can be attributed to innovative pathways and judicious use of resources by both the Endocrinology and Surgical teams in our tertiary centre.