Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, UK; The University of Dundee, UK.
Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, UK; The University of Dundee, UK.
Surgeon. 2021 Oct;19(5):e230-e236. doi: 10.1016/j.surge.2020.10.002. Epub 2020 Nov 19.
Elective orthopaedic operations were suspended at the start of the COVID-19 lockdown. Three pathways were created to allow patients to undergo urgent elective operations in NHS Tayside as soon as it was deemed safe to do so.
We examined elective orthopaedic activity in NHS Tayside during and immediately after the Scottish lockdown. Elective operations performed between 27 March 2020 and 10 August 2020 were included and compared with cases performed between 27 March and 10 August in both 2018 and 2019. Primary outcomes were 30-day mortality, 30-day complications, and nosocomial infection rates of COVID-19.
Fewer elective operations were performed in 2020 (258) compared with 2019 (1196) and 2018 (1261). The rate of nosocomial infection in the 2020 cohort was 0%. The 30-day mortality rate was 0%. Over 98% of patients agreed to undergo surgery after a detailed consenting process.
We were able to re-start a safe elective orthopaedic service in the early stages of recovery from the COVID-19 pandemic, compatible with the guidelines set by the Royal College of Surgery of England and the British Orthopaedic Association. Our findings will serve to reassure regions with sufficient resources that it is acceptable to restart elective surgery for urgent priority cases. They may provide a template for planned surgical care in the event of further pandemics.
在 COVID-19 封锁开始时，择期骨科手术暂停。为了在泰赛德 NHS 尽快安全地为有紧急需求的患者进行择期手术，创建了 3 条途径。
我们检查了苏格兰封锁期间和之后泰赛德 NHS 的择期骨科活动。纳入了在 2020 年 3 月 27 日至 2020 年 8 月 10 日期间进行的择期手术，并与 2018 年和 2019 年同期的 27 日至 3 月 10 日期间进行的病例进行比较。主要结局为 30 天死亡率、30 天并发症和 COVID-19 的医院感染率。
与 2019 年（1196 例）和 2018 年（1261 例）相比，2020 年进行的择期手术较少（258 例）。2020 队列的医院感染率为 0%。30 天死亡率为 0%。在详细的同意程序后，超过 98%的患者同意接受手术。
我们能够在 COVID-19 大流行恢复期的早期重新启动安全的择期骨科服务，符合英格兰皇家外科学院和英国骨科协会制定的指南。我们的发现将使资源充足的地区放心，重新启动紧急优先病例的择期手术是可以接受的。它们可能为进一步大流行时的计划手术护理提供模板。
