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术前 COVID-19 筛查结果与普通人群的感染发病率相关——一项三级护理经验。

Results of preoperative screening for COVID-19 correlate with the incidence of infection in the general population -a tertiary care experience.

机构信息

Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, United States.

Infectious Disease Department, Cleveland Clinic Florida, Weston, United States.

出版信息

Hosp Pract (1995). 2021 Aug;49(3):216-220. doi: 10.1080/21548331.2021.1898158. Epub 2021 Mar 14.

Abstract

: Many hospitals have recently instituted policies mandating preoperative COVID-19 testing. However, it is uncertain whether institutions can dictate such policies based on infection rates found in the general population. Therefore, the main aims of the study were to determine (1) what proportion of preoperative patients tested positive, (2) what percentage was asymptomatic, and (3) whether variations throughout time in numbers of positive patients reflected changes observed in our state.Methods: All COVID-19 preoperative screening tests (nasopharyngeal-swab RT-PCR testing) performed in our hospital between 04/13/2020 and 08/27/2020 were retrospectively reviewed. The unit of analysis was number of patients who tested negative/positive. Medical records of positive patients were reviewed to determine the presence of COVID-19 symptoms. A curve was created showing our number of positive patients per week and another one presenting the number of positive patients per day in Florida, both figures were compared.: A total of 7,213 patients from all specialties were preoperatively tested, out of which 85 were positive for an overall infection rate of 1.2%. In 18% (15/85) of positive patients, it was not possible to determine symptomatology. Among remaining patients, 49% (34/70) were asymptomatic while 51% (36/70) were symptomatic for COVID-19. Peak of positive cases occurred in mid-July in both curves, and the upward and downward tendencies in positive numbers mirrored each other.: COVID-19 infection rate among our preoperative patients was very low. Nearly 50% of positive patients were asymptomatic. Our data suggest that a tertiary hospital can promulgate COVID-19 preoperative screening policies based on infection trends observed in the general population. However, in addition to the test, patients should be encouraged to self-quarantine for 14 days before surgery.

摘要

许多医院最近制定了术前 COVID-19 检测的政策。然而,尚不确定医院是否可以根据一般人群中的感染率来制定此类政策。因此,该研究的主要目的是确定:(1)术前患者中检测呈阳性的比例;(2)无症状的比例;(3)阳性患者数量随时间的变化是否反映了我们州观察到的变化。

方法

回顾性分析了我院于 2020 年 4 月 13 日至 8 月 27 日期间进行的所有 COVID-19 术前筛查检测(鼻咽拭子 RT-PCR 检测)。分析单位为检测阴性/阳性的患者数量。对阳性患者的病历进行审查,以确定是否存在 COVID-19 症状。绘制了一条显示我们每周阳性患者人数的曲线,另一条显示佛罗里达州每天阳性患者人数的曲线,对这两条曲线进行了比较。

结果

共有来自所有科室的 7213 名患者接受了术前检测,其中 85 人检测呈阳性,总体感染率为 1.2%。在 18%(15/85)的阳性患者中,无法确定症状。在其余患者中,49%(34/70)无症状,51%(36/70)有 COVID-19 症状。两条曲线中的阳性病例峰值均出现在 7 月中旬,阳性人数的上升和下降趋势相互呼应。

结论

我们术前患者的 COVID-19 感染率非常低。近 50%的阳性患者无症状。我们的数据表明,一家三级医院可以根据一般人群中观察到的感染趋势来推行 COVID-19 术前筛查政策。但是,除了检测外,还应鼓励患者在手术前自行隔离 14 天。

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