与大流行前相比，COVID-19 大流行期间脆性髋部骨折的手术治疗导致术后短期功能结果较差和并发症发生率较高。

Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period.

机构信息

Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Osteoporos Int. 2022 Oct;33(10):2217-2226. doi: 10.1007/s00198-022-06485-w. Epub 2022 Jul 9.

DOI:10.1007/s00198-022-06485-w

PMID:35809122

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9540207/

Abstract

UNLABELLED

The COVID-19 pandemic adversely affected the functional outcomes of fragility hip fracture patients. This study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among patients treated during the pandemic. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods.

INTRODUCTION

This study aims to investigate the in-hospital complication rate and short-term postoperative functional outcomes of fragility hip fracture (FHF) patients compared between during the COVID-19 pandemic and the same 14-month time period 1 year prior to the pandemic.

METHODS

Using data from the Siriraj Fracture Liaison Service registry, FHF patients treated during the COVID-19 pandemic (1 March 2020 to 30 April 2021) were time-matched with FHF patients treated during the pre-pandemic period (1 March 2018 to 30 April 2019). We collected the rate of in-hospital postoperative complications and the postoperative functional outcomes at discharge and 3 months as measured by the Barthel Index (BI) and EuroQol visual analog scale (EQ-VAS). Functional outcome measures were compared between the pre-pandemic and pandemic periods.

RESULTS

There were 197 and 287 patients in the pre-pandemic and pandemic groups, respectively. At the 3-month postoperative follow-up, the mean postoperative BI score and change in BI score were both significantly lower in the pandemic group indicating poorer postoperative function. Moreover, FHF patients treated during the pandemic had significantly more in-hospital complications (36.6% vs. 22.8%, p = 0.002). There was no significant difference in the 3-month EQ-VAS or change in the EQ-VAS between groups.

CONCLUSION

The results of this study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among FHF patients treated during the COVID-19 pandemic compared to the pre-pandemic period. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods.

摘要

目的

本研究旨在比较 COVID-19 大流行期间与大流行前 14 个月同期收治的脆性髋部骨折（FHF）患者的住院并发症发生率和短期术后功能结局。

方法

利用 Siriraj 骨折联络服务登记处的数据，将 COVID-19 大流行期间（2020 年 3 月 1 日至 2021 年 4 月 30 日）收治的 FHF 患者与大流行前同期（2018 年 3 月 1 日至 2019 年 4 月 30 日）收治的 FHF 患者进行时间匹配。我们收集了住院术后并发症发生率和出院时及 3 个月时的术后功能结局，采用巴氏指数（BI）和欧洲五维健康量表视觉模拟评分（EQ-VAS）进行评估。比较了大流行前和大流行期间的功能结局测量值。

结果

大流行前组和大流行组分别有 197 例和 287 例患者。在术后 3 个月随访时，大流行组的术后 BI 评分平均值和 BI 评分变化均明显较低，表明术后功能较差。此外，大流行期间治疗的 FHF 患者住院并发症明显更多（36.6% vs. 22.8%，p = 0.002）。两组间 3 个月 EQ-VAS 或 EQ-VAS 变化无显著差异。