Fahy Stephen, Moore Joss, Kelly Michael, Irwin Shane, Kenny Paddy
Connolly Hospital Blanchardstown, Dublin, Ireland.
Midlands Regional Hospital, Tullamore, Offaly, Ireland.
Geriatr Orthop Surg Rehabil. 2020 Oct 22;11:2151459320969377. doi: 10.1177/2151459320969377. eCollection 2020.
COVID-19 has placed a huge burden on healthcare systems which has led to widespread cancellation elective surgical care. Ireland is recovering from the first wave of COVID-19 and as such the expeditious return of elective surgical care is important. This is the first study to examine the attitudes of patients to undergoing total joint arthroplasty during the COVID-19 crisis.
A prospective qualitative study was undertaken in our institution during the week 13/05/2020-20/05/2020. 65 patients completed a questionnaire assessing attitudes, awareness, and behavioral changes associated with COVID-19, a Charlson Comorbidity Index, modified-Harris Hip Score, and a Short Form-12 score.
86% of patients felt that they were at little to no risk of COVID-19 infection. The majority of patients were happy to proceed with surgery at the current level of COVID-19 related threat (86%). Patients with higher mHHS were more likely to postpone their operation than those with lower mHHS scores. Our cohort had low patient reported outcome measures in both mHHS and SF-12, indicating the significant burden of hip osteoarthritis on both physical and mental health.
Patients reported a significant disease-related impairment of physical function and subsequent deterioration in mental health as a result of hip osteoarthritis. Patients with worse hip function, as measured by the mHHS are more willing to proceed with surgery than those with superior hip function. This offers a potential mechanism by which to triage patients once elective surgical pathways reopen in the coming months.
新型冠状病毒肺炎（COVID-19）给医疗系统带来了巨大负担，导致择期手术护理被广泛取消。爱尔兰正在从第一波COVID-19疫情中恢复，因此，择期手术护理的迅速恢复很重要。这是第一项研究COVID-19危机期间患者对接受全关节置换术态度的研究。
2020年5月13日至20日在我们机构进行了一项前瞻性定性研究。65名患者完成了一份问卷，评估与COVID-19相关的态度、意识和行为变化、查尔森合并症指数、改良哈里斯髋关节评分和简短健康调查问卷12项评分。
86%的患者认为他们感染COVID-19的风险很小或没有风险。大多数患者愿意在当前与COVID-19相关的威胁水平下进行手术（86%）。改良哈里斯髋关节评分较高的患者比评分较低的患者更有可能推迟手术。我们的队列在改良哈里斯髋关节评分和简短健康调查问卷12项评分中患者报告的结局指标都较低，表明髋骨关节炎对身心健康有重大负担。
患者报告称，由于髋骨关节炎，身体功能出现了与疾病相关的显著损害，随后心理健康也出现了恶化。以改良哈里斯髋关节评分衡量，髋关节功能较差的患者比髋关节功能较好的患者更愿意接受手术。这提供了一种潜在机制，可在未来几个月择期手术途径重新开放时对患者进行分类。
