在接受骨科手术的患者中,术前COVID-19阳性和急性术后并发症风险之间的关联
Michael R Mercier1, Robert Koucheki2,3, Johnathan R Lex1,3
1University of Toronto Division of Orthopaedic Surgery, Toronto, Canada.
Bone & joint open
|September 13, 2023
概括
接受骨科手术的COVID-19患者面临更高的术后并发症风险,包括死亡和肺炎. 部/膝关节整形术和创伤手术对这些患者构成最大的风险.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- COVID-19大流行影响了全球的外科手术护理.
- 了解COVID-19患者的术后风险对于患者的安全至关重要.
- 以前的研究表明潜在的风险增加,但需要针对骨科手术的具体数据.
研究的目的:
- 为了调查30天术后并发症的风险,在接受常见骨科手术的COVID-19阳性检测的患者中.
- 确定与增加不良事件相关的特定程序和患者因素.
主要方法:
- 利用了国家外科质量改进计划 (NSQIP) 数据库,用于2021年1月至12月期间接受骨科手术的患者.
- 分析了手术前的COVID-19状态,人口统计,并发症,手术程序和术后并发症.
- 员工倾向性得分匹配和多变量回归以确定30天不良事件的风险因素.
主要成果:
- 在194,121名患者中,740名 (0.38%) 呈COVID-19阳性,糖尿病,心力衰竭和肺部疾病的发病率更高.
- 在COVID-19阳性患者中,整体不良事件,重大/轻微不良事件,死亡,静脉血栓栓塞和肺炎的风险显著增加.
- 关节/膝关节整形和创伤手术与COVID-19阳性患者30天不良事件的最高风险有关.
结论:
- 接受骨科手术的COVID-19阳性患者面临许多30天术后并发症的高风险.
- 部/膝盖关节整形和创伤手术对这一患者群体来说是高风险的手术.
- 临床医生应提高意识,并实施策略,以减轻这些风险在疫情期间.
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