Department of Orthopaedic Surgery, St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA, 18015, USA.
Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Eur J Trauma Emerg Surg. 2022 Aug;48(4):2813-2822. doi: 10.1007/s00068-022-01947-6. Epub 2022 Mar 23.
This study compares orthopedic injuries, procedures, and hospital outcomes of patients presenting to trauma centers in Pennsylvania before and during the COVID-19 pandemic.
A retrospective review of adult patients presenting to hospitals with Pennsylvania Trauma Systems Foundation (PTSF) designations was performed. All patients 18 years of age and older who presented with orthopedic injuries were included. Demographic information, injury and hospital stay details, and mortality were reviewed. Data were compared between the cohorts of patients presenting during April 2020 (COVID cohort) and April 2017, April 2018, and April 2019 (pre-COVID cohort).
Overall, 14,858 patients were reviewed, and 9427 patients were included in this study. There were fewer orthopedic injuries (4868 vs. 6603 yearly mean) in the COVID cohort which led to fewer procedures (1763 vs. 2329 yearly mean). The COVID cohort had a significantly shorter mean hospital length of stay compared to the pre-COVID cohort (4.7 days versus 5.2 days, p = 0.01). A higher mortality rate was seen in the COVID cohort (n = 115, 6.1%) compared to the pre-COVID cohort (n = 305, 4.0%; p < 0.01).
The characteristics of orthopedic injuries sustained by patients presenting to trauma centers during the COVID pandemic were not different from prior to the pandemic. However, there were decreases in the number of orthopedic injuries and procedures accompanied by a 50% increase in mortality seen in these patients during the pandemic. Resources should be appropriately marshalled to prevent rises in-hospital mortality for patients with orthopedic trauma treated during a pandemic.
Level III.
本研究比较了宾夕法尼亚州创伤中心在 COVID-19 大流行前后患者的骨科损伤、手术和住院结果。
对具有宾夕法尼亚州创伤系统基金会 (PTSF) 指定的医院就诊的成年患者进行回顾性审查。所有年龄在 18 岁及以上并伴有骨科损伤的患者均纳入研究。回顾了人口统计学信息、损伤和住院时间细节以及死亡率。将在 2020 年 4 月（COVID 组）和 2017 年、2018 年和 2019 年 4 月（COVID 前组）就诊的患者队列进行比较。
共回顾了 14858 例患者，其中 9427 例患者纳入本研究。COVID 组的骨科损伤（4868 例，年平均）较 COVID 前组（6603 例，年平均）减少，导致手术（1763 例，年平均）减少。COVID 组的平均住院时间较 COVID 前组明显缩短（4.7 天 vs. 5.2 天，p = 0.01）。COVID 组的死亡率明显高于 COVID 前组（115 例，6.1%比 305 例，4.0%；p < 0.01）。
在 COVID 大流行期间，创伤中心就诊患者的骨科损伤特征与大流行前并无不同。然而，在此期间，这些患者的骨科损伤和手术数量减少，死亡率增加了 50%。在大流行期间，应适当调配资源，以防止骨科创伤患者的住院死亡率上升。
III 级。
