From the Tulane University School of Medicine, (Ms. N. N. Kale, Mr. Marsh, and Mr. N. K. Kale), and the Department of Orthopaedic Surgery (Ms. Miskimin and Dr. Mulcahey), Tulane University School of Medicine, New Orleans, LA.
J Am Acad Orthop Surg Glob Res Rev. 2021 Nov 18;5(11):e21.00241. doi: 10.5435/JAAOSGlobal-D-21-00241.
The purpose of this study was to analyze existing literature on musculoskeletal diseases that homeless populations face and provide recommendations on improving musculoskeletal outcomes for homeless individuals.
A comprehensive search of the literature was performed in March 2020 using the PubMed/MEDLINE (1966 to March 2020), Embase (1975 to April 2020), and CINHAL (1982 to 2020) databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for accuracy of reporting, and the Newcastle-Ottawa Scale was used for quality assessment.
Twenty-nine articles met inclusion criteria. Seven studies observed an increased prevalence of musculoskeletal injuries among the homeless population, four observed increased susceptibility to bacterial soft-tissue infection, four observed increased fractures/traumatic injuries, three described increased chronic pain, and six focused on conditions specific to the foot and ankle region.
Homeless individuals often have inadequate access to care and rely on the emergency department for traumatic injuries. These findings have important implications for surgeons and public health officials and highlight the need for evidence-based interventions and increased follow-up. Targeted efforts and better tracking of follow-up and emergency department usage could improve health outcomes for homeless individuals and reduce the need costly late-stage interventions by providing early and more consistent care.
本研究旨在分析无家可归人群面临的肌肉骨骼疾病的现有文献,并就改善无家可归者的肌肉骨骼预后提出建议。
2020 年 3 月,我们使用 PubMed/MEDLINE(1966 年至 2020 年 3 月)、Embase(1975 年至 2020 年 4 月)和 CINHAL(1982 年至 2020 年)数据库进行了全面的文献检索。我们使用系统评价和荟萃分析的首选报告项目来确保报告的准确性,并使用纽卡斯尔-渥太华量表来评估质量。
有 29 篇文章符合纳入标准。7 项研究观察到无家可归人群肌肉骨骼损伤的患病率增加,4 项研究观察到对细菌软组织感染的易感性增加,4 项研究观察到骨折/创伤性损伤增加,3 项研究描述了慢性疼痛增加,6 项研究集中于足部和踝关节的特定疾病。
无家可归者往往难以获得医疗服务,并依赖急诊室治疗创伤性损伤。这些发现对外科医生和公共卫生官员具有重要意义,强调需要进行基于证据的干预,并增加后续护理。有针对性的努力和更好地跟踪后续护理和急诊部门的使用,可以改善无家可归者的健康结果,并通过提供早期和更一致的护理,减少昂贵的后期干预的需求。