Kumar Jayant, Rajak Manoj Kumar, Chaudhary Anil Kumar, Thakur Rajesh
Department of Orthopedics and Joint Replacement, Tata Main Hospital, Jamshedpur, Jharkhand, India.
J Family Med Prim Care. 2022 Mar;11(3):1026-1031. doi: 10.4103/jfmpc.jfmpc_1486_21. Epub 2022 Mar 10.
The objective of this article is to study the impact of coronavirus disease 2019 (COVID-19) pandemic first wave on the in-hospital length of stay of operated proximal femur fractures.
A retrospective analysis of data collected through the electronic record system of the hospital, after applying inclusion and exclusion criteria, was done. The data were collected from the pre-pandemic, early part first wave and later part first wave of COVID-19 pandemic to calculate the average preoperative stay (POS) and total length of stay (LOS) of operated proximal femur fracture patients. Also, a sub-analysis of POS and LOS was done as per age (male/female), sex (<60/≥60 years) and fracture subtype (intertrochanteric, neck of femur and subtrochanteric fracture) of the patients to study if any of these had a significant direct impact on the POS and LOS.
The LOS and POS were found to be significantly increased during early part of first wave of COVID-19 pandemic in comparison to the pre-pandemic era (13.6 ± 7.7 days vs. 11.1 ± 5.7 days). The later part of the first wave of the pandemic however saw the LOS and POS to return to near pre-pandemic values, although still remaining higher.
The study highlights that unpreparedness during the early part of the unprecedented pandemic event leads to a significant increase in LOS of operated patients with its associated implications; however, prompt action by the government, hospital administration and hospital staff the LOS could be reduced to near pre-pandemic values in the later part of the first wave of the pandemic. Analysis of the causes that lead to a significant increase in LOS can help for better future management of similar events in future.
本文旨在研究2019冠状病毒病(COVID-19)大流行第一波对股骨近端骨折手术患者住院时间的影响。
在应用纳入和排除标准后,对通过医院电子记录系统收集的数据进行回顾性分析。数据收集自COVID-19大流行的大流行前、第一波早期和第一波后期,以计算股骨近端骨折手术患者的平均术前住院时间(POS)和总住院时间(LOS)。此外,还根据患者的年龄(男性/女性)、性别(<60/≥60岁)和骨折亚型(粗隆间骨折、股骨颈骨折和转子下骨折)对POS和LOS进行了亚分析,以研究这些因素是否对POS和LOS有显著的直接影响。
与大流行前时期相比,COVID-19大流行第一波早期的LOS和POS显著增加(13.6±7.7天对11.1±5.7天)。然而,大流行第一波后期的LOS和POS虽仍高于大流行前,但已恢复到接近大流行前的值。
该研究强调,在这一前所未有的大流行事件早期缺乏准备会导致手术患者的LOS显著增加及其相关影响;然而,政府、医院管理部门和医院工作人员迅速采取行动,可使大流行第一波后期的LOS降至接近大流行前的值。分析导致LOS显著增加的原因有助于未来更好地管理类似事件。