Riley James, Verma Rajat
Department of Spinal Surgery, Salford Royal NHS Foundation Trust, Salford, UK.
J Spine Surg. 2021 Mar;7(1):62-67. doi: 10.21037/jss-20-643.
The COVID-19 pandemic first came to prominence in December 2019, and since then has swept the globe, causing one of the largest public health problems seen. It has had a wide-ranging impact on healthcare provision, with a cessation of elective operating. We aimed to assess the impact of COVID-19 on a tertiary referral centre for spinal surgery in England.
An 82-day study period from 20 March 2020 to 10 June 2020 was used, and all spinal surgical patients were followed up prospectively, comparing patients from the same date range in 2019. We assessed rate of COVID transmission, 30-day mortality rates, complication rates and length of hospital stay in a large tertiary Teaching hospital in England.
Seventy-eight patients were operated on during the COVID-19 pandemic period, with a 30-day mortality rate of 4.2%. Two of these deaths were attributable to COVID-19 (2.56%). The mean length of stay was 10.8 days. Neither the 30-day mortality rate or the length of stay was statistically significant compared to the 2019 control period. Five patients (6.4%) tested positive for COVID-19, all were negative at time of surgical intervention. Our complication rate was 10.3% during the COVID-19 pandemic period.
The number of operative cases performed during the COVID-19 pandemic fell by one-third compared to the same period in 2019. The COVID-19 pandemic did not cause a significant increase in 30-day mortality rate, length of stay, or complication rates. Further studies with larger patient numbers and longer-term outcomes will be needed to fully assess the impact of the COVID-19 pandemic on spinal surgery.
2019年12月,新型冠状病毒肺炎(COVID-19)疫情首次引起关注,此后席卷全球,成为有史以来最严重的公共卫生问题之一。它对医疗服务产生了广泛影响,导致择期手术暂停。我们旨在评估COVID-19对英国一家脊柱外科三级转诊中心的影响。
采用从2020年3月20日至2020年6月10日的82天研究期,对所有脊柱外科患者进行前瞻性随访,并与2019年同一日期范围内的患者进行比较。我们评估了英国一家大型三级教学医院的COVID传播率、30天死亡率、并发症发生率和住院时间。
在COVID-19疫情期间,有78例患者接受了手术,30天死亡率为4.2%。其中两例死亡归因于COVID-19(2.56%)。平均住院时间为10.8天。与2019年对照期相比,30天死亡率和住院时间均无统计学意义。5例患者(6.4%)COVID-19检测呈阳性,所有患者在手术干预时均为阴性。在COVID-19疫情期间,我们的并发症发生率为10.3%。
与2019年同期相比,COVID-19疫情期间的手术病例数下降了三分之一。COVID-19疫情并未导致30天死亡率、住院时间或并发症发生率显著增加。需要进行更大样本量和长期结局的进一步研究,以全面评估COVID-19疫情对脊柱外科手术的影响。