Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
Universitat Autónoma de Barcelona, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
Int Orthop. 2020 Dec;44(12):2505-2513. doi: 10.1007/s00264-020-04798-1. Epub 2020 Sep 11.
The purpose of the present study is to analyse clinical data of a series of cases who developed nosocomial infection with SARS-CoV-2 in an orthopaedic and traumatology department.
In this non-interventional retrospective study, carried out at a tertiary hospital within the Spanish National Health System, all adult patients who were admitted in the Orthopaedic Surgery and Traumatology Department between March 9th and May 4th, 2020, were included. Clinical, biological and radiological data, as well as mortality rates, were collected from hospital medical records.
A total of 293 periods of hospitalization were analysed in 288 patients. Mean age was 66.1 years old and 57.3% were females. Nineteen patients (6.48%) met the inclusion criteria to be categorized as a nosocomial infection with SARS-CoV-2. In a comparison between patients with and without nosocomial infection, age, mortality and hospital length of stay were statistically significant (p < 0.05). The median time from admission to diagnosis of SARS-CoV-2 infection in our cohort was 16 days (6-86 days). No statistically significant differences were found in sex, living situation, reason of admission or period of admission (even if we observed that most of the nosocomial infections (78.9%) occurred in March).
We have found a 6.48% of nosocomial infection with SARS-CoV-2, but with an important reduction of it after undergoing preventing protocols that included screening RT-PCR test for COVID-19. Age and hospital length stay were statistically significant risk factors for nosocomial infection with SARS-CoV-2. For the progressive restoration of the surgical activity, we recommend to correctly select the patients in elective surgery and to encourage fast-track programs and early discharge of patients with fractures.
本研究旨在分析一家骨科和创伤科发生的一系列医院获得性 2019 冠状病毒病（SARS-CoV-2）感染病例的临床数据。
本回顾性非干预性研究在一家西班牙国家卫生系统的三级医院进行，纳入 2020 年 3 月 9 日至 5 月 4 日期间入住骨科和创伤科的所有成年患者。从医院病历中收集临床、生物学和影像学数据以及死亡率。
分析了 288 例患者的 293 个住院期。患者平均年龄为 66.1 岁，57.3%为女性。19 例（6.48%）患者符合纳入标准，归类为医院获得性 SARS-CoV-2 感染。在有和无医院获得性感染的患者之间比较，年龄、死亡率和住院时间具有统计学意义（p<0.05）。本队列中从入院到诊断 SARS-CoV-2 感染的中位时间为 16 天（6-86 天）。我们未发现性别、居住情况、入院原因或入院期间有统计学显著差异（尽管我们观察到大多数医院获得性感染（78.9%）发生在 3 月）。
我们发现有 6.48%的患者发生医院获得性 SARS-CoV-2 感染，但通过实施包括对 COVID-19 进行 RT-PCR 筛查的预防方案，感染率显著降低。年龄和住院时间是医院获得性 SARS-CoV-2 感染的统计学显著危险因素。为了逐步恢复手术活动，我们建议正确选择择期手术患者，并鼓励采用快速通道方案和尽早出院骨折患者。
