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COVID-19 大流行对髋部骨折老年患者死亡率的影响。

Impact of the COVID-19 pandemic on the mortality of the elderly patient with a hip fracture.

机构信息

Departamento de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.

Departamento de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2021 Feb;68(2):65-72. doi: 10.1016/j.redar.2020.10.003. Epub 2020 Oct 21.

Abstract

UNLABELLED

COVID-19 became a threat to the public health system, compromising the health of the population. Patients with hip fractures, due to their age and comorbidity, were high-risk patients in this pandemic. The purpose of this study was to observe how the pandemic affected the management of hip fractures in elderly patients.

METHODS

This is a descriptive, retrospective study of all patients over the age of 65 diagnosed with a hip fracture that came to the emergency room of Vall d'Hebron University Hospital in the COVID-19 pandemic period, from the 11th of March to the 24th of April 2020. They were followed up during their hospital stay and 30 days after the fracture.

RESULTS

A total of 63 patients were included, 18 (28.6%) of whom had a positive RT-qPCR for COVID-19. Four could not be operated on due to the severity of the disease they presented with upon admission, dying a few days afterwards. Three of these patients had COVID-19. The 83.3% of the patients with positive RT-qPCR presented respiratory symptoms during their hospitalization. The length of hospital stays of patients with a positive RT-qPCR (18.25±8.99 days) was longer than that of patients that were RT-qPCR negative (10.9±4.52 days) (P=.01). In-hospital mortality in operated patients was 20% in patients with a positive RT-qPCR, compared with 2.3% in the group of patients who tested negative (P=.018). Mortality at 30 days was 40% in the group with positive RT-qPCR vs 6.8% in patients not infected by SARS-CoV-2 (P=.002).

CONCLUSION

SARS-CoV-2 infection in elderly patients with hip fractures increases both the length of hospital stay, as well as in-hospital and 30-day mortality.

摘要

目的

观察大流行如何影响老年髋部骨折患者的管理。

方法

这是一项描述性、回顾性研究,纳入了所有在 2020 年 3 月 11 日至 4 月 24 日 COVID-19 大流行期间因髋部骨折而来到 Vall d'Hebron 大学医院急诊科的 65 岁以上患者。在住院期间和骨折后 30 天对他们进行了随访。

结果

共纳入 63 例患者,其中 18 例(28.6%)的 RT-qPCR 检测结果为 COVID-19 阳性。有 4 例患者因入院时的疾病严重程度而无法进行手术,几天后死亡。其中 3 例患者 COVID-19 阳性。在住院期间,83.3%的 RT-qPCR 阳性患者出现呼吸道症状。RT-qPCR 阳性患者的住院时间(18.25±8.99 天)长于 RT-qPCR 阴性患者(10.9±4.52 天)(P=.01)。接受手术的患者中,RT-qPCR 阳性患者的住院内死亡率为 20%,而 RT-qPCR 阴性患者的死亡率为 2.3%(P=.018)。在 RT-qPCR 阳性组中,30 天死亡率为 40%,而在未感染 SARS-CoV-2 的患者中为 6.8%(P=.002)。

结论

SARS-CoV-2 感染老年髋部骨折患者会增加住院时间以及住院内和 30 天死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b153/7577732/5e43a73ac142/fx1_lrg.jpg

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