Ribau Ana, Vale João, Xará-Leite Francisco, Rodrigues-Pinto Ricardo
Department of Orthopaedics, Centro Hospitalar Universitário do Porto.
ICBAS-Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal.
Porto Biomed J. 2021 Jan 18;6(1):e109. doi: 10.1097/j.pbj.0000000000000109. eCollection 2021 Jan-Feb.
The coronavirus disease-2019 pandemic has forced health systems to undergo dynamic changes. This study aims to evaluate the impact of the pre-lockdown and of the lockdown period on the surgical activity of a Portuguese Orthopaedic and Traumatology Department and to compare it with the homologous period of 2019.
The surgical activity between March 2 and May 2, 2020 and that of the homologous period of 2019 were analyzed and compared. Additionally, the impact of national and institutional measures was analyzed.
There was a decrease in elective surgeries, from 587 to 100. In 2020, 59.3% of all surgeries were urgent and 48.4% were trauma whereas in 2019 there were 25.5% urgent and 23.0% trauma surgeries ( < .001 and < .001, respectively). There was no difference in the mean of proximal hip fractures operated per week ( = .310), even when analyzing only the lockdown period ( = .102). However, proximal hip fractures corresponded to significantly higher proportion of surgeries in 2020 ( = .04). Hand and tendon injuries significantly reduced in 2020, as were sports-related trauma surgeries. Mean number of days until surgery was significantly lower in 2020 (2020:1.6 ± 2.1, 2019: 2.2 ± 2.5, = .012).
Governmental and institutional measures had high impact on the production and on the epidemiology of trauma. While resumption of elective surgery is needed, lessons from these measures may help in the response to a possible second wave.
2019年冠状病毒病大流行迫使卫生系统发生动态变化。本研究旨在评估封锁前和封锁期间对葡萄牙一家骨科和创伤科手术活动的影响,并将其与2019年的同期情况进行比较。
分析并比较了2020年3月2日至5月2日期间的手术活动以及2019年同期的手术活动。此外,还分析了国家和机构措施的影响。
择期手术数量从587例减少至100例。2020年,所有手术中有59.3%为急诊手术,48.4%为创伤手术;而2019年急诊手术占25.5%,创伤手术占23.0%(分别为<0.001和<0.001)。每周手术的近端髋部骨折平均数量没有差异(P = 0.310),即使仅分析封锁期间也是如此(P = 0.102)。然而,2020年近端髋部骨折在手术中所占比例显著更高(P = 0.04)。2020年手部和肌腱损伤显著减少,与运动相关的创伤手术也是如此。2020年手术前的平均天数显著更低(2020年:1.6±2.1,2019年:2.2±2.5,P = 0.012)。
政府和机构措施对创伤的发生情况和流行病学有很大影响。虽然需要恢复择期手术,但这些措施带来的经验教训可能有助于应对可能出现的第二波疫情。