Hsu Chia-Hao, Hsu Nin-Chieh
Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan.
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
J Clin Med. 2021 Nov 19;10(22):5392. doi: 10.3390/jcm10225392.
The real psychological impact of COVID-19 remains difficult to quantify and may differ between hospital sizes and levels. Taiwan's response to COVID-19 differed in that it successfully prevented its spread, without implementing any lockdowns before May 2021. Patients' fear would be the major reason for the reduction of surgeries. The daily data for patients who underwent total knee arthroplasty (TKA), total hip arthroplasty, and hemiarthroplasty were collected from two major joint surgery centers of a university hospital and a community hospital in Taiwan. Compared with the previous year, the initial impact of the pandemic evidently reduced the total number of patients (outpatient: 20-29%; admission: 22-37%; surgery: 18-35%) in both hospitals. During the study period, the total number of TKAs decreased by 56-61% in both hospitals. The reduction in arthroplasty surgeries was attributable to patients' fear. Even with confirmed COVID-19 cases, the university hospital experienced less impact than the community hospital. The TKA was the most affected of all surgery types. Even without local epidemics and restrictions in Taiwan, the worldwide pandemic inevitably led to a reduction of approximately 60% of the total TKA operation volume, especially for community hospitals. The surgery scheduling strategies helped maintain the routine arthroplasty services.
新冠疫情的实际心理影响仍难以量化，且可能因医院规模和级别而异。台湾地区应对新冠疫情的方式有所不同，它成功阻止了疫情传播，在2021年5月之前未实施任何封锁措施。患者的恐惧可能是手术量减少的主要原因。从台湾一所大学医院和一家社区医院的两个主要关节手术中心收集了接受全膝关节置换术（TKA）、全髋关节置换术和半髋关节置换术患者的每日数据。与上一年相比，疫情初期的影响明显减少了两家医院的患者总数（门诊量：20%-29%；住院量：22%-37%；手术量：18%-35%）。在研究期间，两家医院的TKA总数均下降了56%-61%。关节置换手术量的减少归因于患者的恐惧。即使有确诊的新冠病例，大学医院受到的影响也比社区医院小。TKA是所有手术类型中受影响最大的。即使台湾地区没有本地疫情和限制措施，全球疫情仍不可避免地导致TKA手术总量减少了约60%，尤其是社区医院。手术安排策略有助于维持常规的关节置换手术服务。
