在COVID-19期间的关节骨折护理:在大流行期间的进化
Sanjit R Konda1,2, Garrett W Esper2, Ariana T Meltzer-Bruhn3,2
1Orthopedic Surgery, Jamaica Hospital Medical Center, New York, USA.
Cureus
|September 1, 2023
概括
在大流行期间,部骨折护理保持一致. 虽然流行病的早期阶段死亡率较高,但改善的理解和疫苗降低了COVID-19的死亡率.
科学领域:
- 老年医学 老年医学
- 流行病学 流行病学
- 整形外科手术 整形外科手术
背景情况:
- 部骨折对中年和老年人群构成重大健康风险.
- 在全球范围内,COVID-19大流行给医疗保健系统带来了前所未有的挑战.
- 了解大流行对关节骨折患者护理的影响对于保持最佳治疗标准至关重要.
研究的目的:
- 在COVID-19大流行期间分析一个机构的关节骨折患者护理.
- 为了比较流行病前,流行病早期 (疫苗前) 和流行病后 (疫苗后) 阶段的护理和结果.
- 评估COVID-19和疫苗接种状态对关节骨折患者管理的影响.
主要方法:
- 从2014年10月到2022年1月,对2633名关节骨折患者 (>55岁) 的流行病学研究.
- 患者被分为COVID-19前 (PRECOV),COVID-19疫苗前 (PREVAX) 和COVID-19疫苗后 (POSTVAX) 队列.
- 对人口统计,COVID-19状态,损伤特征,质量措施和结果的比较分析,其中包括不包括COVID-19阳性患者的子分析.
主要成果:
- 在不同队列 (PRECOV,PREVAX,POSTVAX) 的住院患者死亡率中没有显著差异.
- 在PRECOV队列中,30天死亡率较低 (p=0.012) 和住院时间较长 (p<0.01).
- PREVAX患者需要更多的ICU护理 (p<0.01);并发症发生率不同 (p<0.01). 除了COVID-19阳性患者之外,整个队列的死亡率相似.
结论:
- 机构关节骨折护理协议在整个大流行期间保持一致.
- 在PREVAX队列中死亡率的增加归因于COVID-19的影响,疫苗引入后的死亡率下降.
- 建议继续使用疫情前的关节骨折护理方案.
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