COVID-19大流行对髋关节骨折患者流行病学、管理和生存的影响

V. CLIMENT-PERIS, F. PAULOS DOS SANTOS, R. PÉREZ GINER, M. OJEDA PEÑA
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引用次数: 0

摘要

COVID-19大流行迫使对卫生资源进行重组,以治疗严重呼吸综合征患者。虽然创伤性病理的发生率降低了,但髋部骨折的情况并非如此,而且他们的治疗可能会受到损害。本研究的目的是评估大流行对髋部骨折的流行病学、治疗和预后的影响。材料和方法:对2019年3月至2021年2月期间接受治疗的髋部骨折患者进行了一项回顾性观察队列研究,建立了两组进行比较,分别是在大流行爆发之前和之后。记录人口统计学变量、合并症、脆性骨折和髋部骨折史、骨折类型和治疗类型、手术延迟、住院时间和入院时SARS-CoV2 PCR结果。分析1个月和6个月住院死亡率和生存率。结果:纳入251例患者,其中PRE-COVID组137例(54.58%),POST-C组114例(45.42%)。在人口统计学变量、合并症、骨折类型或治疗方面没有差异。绝对发病率下降16.8%,相对发病率下降17.6%,在封锁期间和1月和2月前的最高发病期差异显著。入院时PCR +的发生率为1.75%。手术延迟、住院时间、死亡率、1个月和6个月生存率均无显著差异。结论:随着COVID-19大流行,髋部骨折发生率明显下降,其流行病学、医院管理指标以及患者1个月和6个月生存率均未发生变化。
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IMPACTO DE LA PANDEMIA POR COVID-19 EN LA EPIDEMIOLOGÍA, MANEJO Y SUPERVIVENCIA DE LOS PACIENTES CON FRACTURA DE CADERA
The COVID-19 pandemic has forced a reorganization of health resources towards the care of patients with severe respiratory syndrome. While the incidence of traumatic pathology was reduced, this was not the case with hip fractures, and their management could be compromised. The objective of this study is to evaluate the consequences of the pandemic on the epidemiology, management and outcomes of hip fracture. Material and methods: A retrospective observational cohort study was done including patients with hip fracture treated between March 2019 and February 2021, establishing two groups for comparison, before and after the onset of the pandemic. Demographic variables, comorbidities, history of fragility fracture and hip fracture, type of fracture and type of treatment performed, surgical delay, length of hospital stay, and PCR result for SARS-CoV2 upon admission were recorded. In-hospital mortality rate and survival at 1 and 6 months were analyzed. Results: 251 patients were included, 137 (54.58%) PRE-COVID group and 114 (45.42%) POST-C group. There were no differences in demographic variables, comorbidities, type of fracture, or treatment performed. The absolute incidence was reduced by 16.8% and the relative incidence was reduced by 17.6%, this difference was significant during lockdown period and in the months o January and February, the period of maximum incidence of COVID-19. The incidence of PCR + on admission was 1.75%. No significant differences were found in surgical delay, hospital stay and mortality, survival at one month or at 6 months. Conclusion: With the COVID-19 pandemic, specific reductions in the incidence of hip fractures have been observed, without changes in its epidemiology, indicators of hospital management and in patient survival at one and 6 months.
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