COVID-19对恢复选择性关节置换术和种族差异的影响有限。

Q4 Medicine Hawai''i journal of health & social welfare Pub Date : 2023-03-01
Krystin Wong, Samantha N Andrews, Cass K Nakasone
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引用次数: 0

摘要

为应对COVID-19大流行,联邦和州的建议包括推迟选择性关节置换术,直到能够实施适当的安全措施。在恢复关节置换术后,暴露恐惧和经济担忧可能限制了一些人口统计数据的使用。因此,本研究的目的是:(1)调查COVID-19大流行对关节置换术发病率的总体影响和不同人口统计数据的影响,以及(2)评估在大流行期间术前患者报告的措施是否不同。作为2019年1月至2021年4月期间现场联合登记的一部分,前瞻性地收集了数据。第一阶段(N=518)包括取消选择性手术前的所有患者(平均36例/月),第二阶段(N=121)定义为从重新开始到每月病例量达到/超过第一阶段平均病例量(5个月),第三阶段(N=277)包括所有剩余病例。采用多元方差分析和卡方检验比较不同阶段患者的人口统计学特征和结果。在2期期间,除了夏威夷原住民/太平洋岛民患者减少和亚洲患者增加外,患者人口统计学上没有显著差异(P = 0.004)。单侧关节置换术的住院时间从1期(0.9±1.1天)减少到2期(0.4±0.6天)和3期(0.6±0.7天)
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COVID-19 had Limited Impact on Resumption of Elective Joint Arthroplasty and Ethnic Disparities.

In response to the COVID-19 pandemic, federal and state recommendations included the postponement of elective arthroplasties until adequate safety measures could be implemented. Following resumption of arthroplasties, exposure fears and financial concerns may have restricted access for some demographics. Therefore, the purpose of this study was to (1) investigate how the COVID-19 pandemic impacted the incidence of arthroplasty, both overall and by various demographics, and (2) evaluate if pre-operative patient-reported measures were different throughout the pandemic. Data were collected prospectively as part of an on-site joint registry between January 2019 and April 2021. Phase 1 (N=518) included all patients prior to the cancelation of elective procedures (average 36 cases/month), Phase 2 (N=121) was defined from restart until monthly caseload met/surpassed the average Phase 1 caseload (5 months), and Phase 3 (N=277) included all remaining cases. Multiple analysis of variance and chi-squared tests were performed to compare patient demographics and outcomes between phases. No significant differences were noted in patient demographics, with the exception of a decrease in Native Hawaiian/Pacific Islander patients and an increase in Asian patients during Phase 2 (P =.004). Length of stay decreased for unilateral arthroplasty from Phase 1 (0.9±1.1 days) to Phase 2 (0.4±0.6 days) and Phase 3 (0.6±0.7 days) (P <.001), while pre-operative patient reported outcomes remained similar across the 3 time periods. By implementing proper safety measures, the current orthopedic center achieved a timely recovery with no long-lasting inconsistencies in patient cohorts upon resumption of arthroplasties.

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