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骨科、创伤外科和 2019 年冠状病毒病大流行:欧洲的临床概况和未来展望。

Orthopaedic, trauma surgery, and Covid-2019 pandemic: clinical panorama and future prospective in Europe.

机构信息

Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.

Department of Orthopaedic Surgery, Klinikum Ernst Von Bergmann, Potsdam, Germany.

出版信息

Eur J Trauma Emerg Surg. 2022 Dec;48(6):4385-4402. doi: 10.1007/s00068-022-01978-z. Epub 2022 May 6.

Abstract

PURPOSE

This study investigated the impact of the Covid-19 pandemic in Europe on consultations, surgeries, and traumas in the field of orthopaedic and trauma surgery. Strategies to resume the clinical activities were also discussed.

METHODS

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. All the comparative studies reporting data on the impact of Covid-19 in the field of orthopaedic and trauma surgery in Europe were accessed. Only comparative clinical studies which investigated the year 2020 versus 2019 were eligible.

RESULTS

57 clinical investigations were included in the present study. Eight studies reported a reduction of the orthopaedic consultations, which decreased between 20.9 and 90.1%. Seven studies reported the number of emergency and trauma consultations, which were decreased between 37.7 and 74.2%. Fifteen studies reported information with regard to the reasons for orthopaedic and trauma admissions. The number of polytraumas decreased between 5.6 and 77.1%, fractures between 3.9 and 63.1%. Traffic accidents admissions dropped by up to 88.9%, and sports-related injuries dropped in a range of 59.3% to 100%. The overall reduction of the surgical interventions ranged from 5.4 to 88.8%.

CONCLUSION

The overall trend of consultations, surgeries, and rate of traumas and fragility fractures appear to decrease during the 2020 European COVID pandemic compared to the pre-pandemic era. Given the heterogeneities in the clinical evidence, results from the present study should be considered carefully.

LEVEL OF EVIDENCE

Level IV, systematic review.

摘要

目的

本研究调查了欧洲新冠疫情对矫形和创伤外科领域的就诊、手术和创伤的影响。还讨论了恢复临床活动的策略。

方法

本系统评价按照系统评价和荟萃分析的首选报告项目:2020 年 PRISMA 声明进行。所有报告了欧洲矫形和创伤外科领域新冠疫情影响的比较研究均被纳入。只有调查 2020 年与 2019 年相比的比较临床研究才符合条件。

结果

本研究共纳入 57 项临床研究。8 项研究报告了矫形就诊减少,减少幅度为 20.9%至 90.1%。7 项研究报告了急诊和创伤就诊数量减少,减少幅度为 37.7%至 74.2%。15 项研究报告了与矫形和创伤入院相关的原因信息。多发伤减少了 5.6%至 77.1%,骨折减少了 3.9%至 63.1%。交通事故入院减少了高达 88.9%,运动相关损伤减少了 59.3%至 100%。手术干预的总体减少幅度为 5.4%至 88.8%。

结论

与大流行前相比,2020 年欧洲 COVID 大流行期间,就诊、手术和创伤发生率以及脆弱性骨折的总体趋势似乎有所下降。鉴于临床证据的异质性,本研究的结果应谨慎考虑。

证据水平

IV 级,系统评价。

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