Cardiff and Vale University Health Board, Cardiff, UK.
Ann R Coll Surg Engl. 2021 May;103(5):332-336. doi: 10.1308/rcsann.2020.7025. Epub 2021 Mar 8.
COVID-19 has necessitated significant changes to healthcare delivery but little is known regarding patient opinions of risks compared with benefits. This study investigates patient perceptions concerning attendance for planned orthopaedic surgery during the COVID-19 pandemic.
A total of 250 adult patients from the elective orthopaedic waiting list at Cardiff and Vale University Health Board were telephoned during lockdown. They were risk stratified for COVID-19 based on British Orthopaedic Association guidance and a discussion was held to determine patient willingness to proceed with surgery. The primary outcome measure was patients' willingness to proceed.
Of the total number telephoned, 196 patients were included in the study, with a mean age of 57.4 years; 129 patients were willing to attend for surgery, leaving over one-third wishing to cancel or defer. The most frequent reason given for not wishing to attend was fear of contracting COVID-19. There was a statistically significant difference in the willingness to proceed observed with increasing clinical risk (χ(3) = 50.073, = .000) with almost double the expected count of unwilling to proceed in the high and very high risk groups, equalled by half the expected count in the low risk group.
This study illustrates the variable and personal decisions that patients are making about orthopaedic care because of COVID-19. It highlights the need for change to departmental processes regarding recommencement of planned surgical lists. It also reconfirms the importance of regular communication and shared decision making between a well-informed patient and a holistic orthopaedic team.
COVID-19 疫情要求医疗服务模式发生重大改变，但对于患者对风险与获益的看法知之甚少。本研究调查了 COVID-19 大流行期间患者对计划行择期骨科手术的看法。
卡迪夫和韦尔大学健康委员会（Cardiff and Vale University Health Board）的骨科择期手术等候名单上的 250 名成年患者在封锁期间接受了电话调查。根据英国矫形外科学会（British Orthopaedic Association）的指南对患者进行 COVID-19 风险分层，并进行讨论以确定患者是否愿意继续进行手术。主要结局测量指标为患者是否愿意继续手术。
在总共被电话调查的患者中，196 名患者被纳入研究，平均年龄为 57.4 岁；129 名患者愿意接受手术，超过三分之一的患者希望取消或推迟手术。最常见的不愿就诊的原因是担心感染 COVID-19。随着临床风险的增加，愿意继续手术的意愿存在统计学显著差异（χ(3) = 50.073， = .000），高风险和极高风险组中不愿意继续手术的预期人数几乎是低风险组的两倍，而在低风险组中不愿意继续手术的预期人数则是低风险组的一半。
本研究说明了 COVID-19 疫情下患者对骨科护理做出的不同个人决定。它强调了需要改变部门流程，重新启动计划手术清单。它还再次证实了患者与全面的骨科团队之间保持定期沟通和共同决策的重要性。
