新冠疫情封锁对骨科创伤的影响：一项横跨苏格兰的多中心研究。
Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland.
作者信息
MacDonald David R W, Neilly David W, Davies Peter S E, Crome Christopher R, Jamal Bilal, Gill Sarah L, Jariwala Arpit C, Stevenson Iain M, Ashcroft G Patrick
机构信息
Department of Trauma and Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK.
Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, UK.
出版信息
Bone Jt Open. 2020 Sep 8;1(9):541-548. doi: 10.1302/2633-1462.19.BJO-2020-0114.R1. eCollection 2020 Sep.
AIMS
The UK government declared a national lockdown on 23 March 2020 to reduce transmission of COVID-19. This study aims to identify the effect of lockdown on the rates, types, mechanisms, and mortality of musculoskeletal trauma across Scotland.
METHODS
Data for all musculoskeletal trauma requiring operative treatment were collected prospectively from five key orthopaedic units across Scotland during lockdown (23 March 2020 to 28 May 2020). This was compared with data for the same timeframe in 2019 and 2018. Data collected included all cases requiring surgery, injury type, mechanism of injury, and inpatient mortality.
RESULTS
A total of 1,315 patients received operative treatment from 23 March 2020 to 28 May 2020 compared with 1,791 in 2019 and 1,719 in 2018. The numbers of all injury types decreased, but the relative frequency of hip fractures increased (36.3% in 2020 vs 30.2% in 2019, p < 0.0001 and 30.7% in 2018, p < 0.0001). Significant increases were seen in the proportion of DIY-related injuries (3.1% in 2020 vs 1.7% in 2019, p = 0.012 and 1.6% in 2018, p < 0.005) and injuries caused by falls (65.6% in 2020 vs 62.6% in 2019, p = 0.082 and 61.9% in 2018, p = 0.047). Significant decreases were seen in the proportion of road traffic collisions (2.6% in 2020 vs 5.4% in 2019, p < 0.0001 and 4.2% in 2018, p = 0.016), occupational injuries (1.8% in 2020 vs 3.0% in 2019, p = 0.025 and 2.3% in 2018, p = 0.012) and infections (6.8% in 2020 vs 7.8% in 2019, p = 0.268 and 10.3% in 2018, p < 0.012). Cycling injuries increased (78 in 2020 vs 64 in 2019 vs 42 in 2018). A significant increase in the proportion of self-harm injuries was seen (1.7% in 2020 vs 1.1% in 2019, p = 0.185 and 0.5% in 2018, p < 0.0001). Mortality of trauma patients was significantly higher in 2020 (5.0%) than in 2019 (2.8%, p = 0.002) and 2018 (1.8%, p < 0.0001).
CONCLUSION
The UK COVID-19 lockdown has resulted in a marked reduction in musculoskeletal trauma patients undergoing surgery in Scotland. There have been significant changes in types and mechanisms of injury and, concerningly, mortality of trauma patients has risen significantly.Cite this article: 2020;1-9:541-548.
目的
英国政府于2020年3月23日宣布全国封锁，以减少新冠病毒的传播。本研究旨在确定封锁对苏格兰肌肉骨骼创伤的发生率、类型、机制和死亡率的影响。
方法
在封锁期间（2020年3月23日至2020年5月28日），前瞻性收集了苏格兰五个主要骨科单位所有需要手术治疗的肌肉骨骼创伤数据。并将其与2019年和2018年同一时间段的数据进行比较。收集的数据包括所有需要手术的病例、损伤类型、损伤机制和住院死亡率。
结果
2020年3月23日至2020年5月28日，共有1315例患者接受了手术治疗，2019年为1791例，2018年为1719例。所有损伤类型的数量均有所下降，但髋部骨折的相对发生率有所增加（2020年为36.3%，2019年为30.2%，p<0.0001；2018年为30.7%，p<0.0001）。与自己动手做（DIY）相关的损伤比例显著增加（2020年为3.1%，2019年为1.7%，p=0.012；2018年为1.6%，p<0.005），跌倒导致的损伤比例也显著增加（2020年为65.6%，2019年为62.6%，p=0.082；2018年为61.9%，p=0.047）。道路交通碰撞导致的损伤比例显著下降（2020年为2.6%，2019年为5.4%，p<0.0001；2018年为4.2%，p=0.016），职业损伤比例下降（2020年为1.8%，2019年为3.0%，p=0.025；2018年为2.3%，p=0.012），感染导致的损伤比例下降（2020年为6.8%，2019年为7.8%，p=0.268；2018年为10.3%，p<0.012）。骑自行车导致的损伤有所增加（2020年为78例，2019年为64例，2018年为42例）。自残损伤比例显著增加（2020年为1.7%，2019年为1.1%，p=0.185；2018年为<.0001）。2020年创伤患者的死亡率显著高于2019年（2.8%，p=0.002）和2018年（1.8%，p<0.0001）。
结论
英国新冠疫情封锁导致苏格兰接受手术的肌肉骨骼创伤患者显著减少。损伤类型和机制发生了显著变化，令人担忧的是，创伤患者的死亡率显著上升。引用本文：2020；1-9:于541-548页。
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