Levašič Vesna, Savarin Denia, Kovač Simon
Valdoltra Orthopaedic Hospital, Research Department, Jadranska cesta 31, 6280 Ankaran, Slovenia.
University of Maribor, Faculty of Medicine, Taborska ulica 8, 2000 Maribor, Slovenia.
Zdr Varst. 2022 Jun 28;61(3):155-162. doi: 10.2478/sjph-2022-0021. eCollection 2022 Sep.
The purpose of the study was to analyse the impact of the COVID-19 pandemic on the healthcare of the orthopaedic patient, i.e. numbers of hip and knee replacement surgeries, 90-day mortality, waiting times and outpatient clinic visits.
The Hip (HR) and Knee Replacement (KR) records from The National Arthroplasty Registry of Slovenia in the pandemic year 2020 were compared to the year 2019. To compare reasons for revision and 90-day mortality the Chi-square test was used. The median values of the number of operations and waiting times were compared with the 95% confidence intervals. The number of outpatient clinic visits was tested with the Wilcoxon Signed Ranked test.
All operations fell by 19%, from 7825 to 6335. The number of Primary Total HR declined from 3530 to 2792 (21%) and the number of Primary KR from 3191 to 2423 (24%). The number of hip revisions declined by 10% and knee revisions by 25%. We did not find differences in 90-day mortality (p=0.408). Outpatient clinic visits fell from 228682 to 196582 (14%) per year. Waiting times increased by 15% for HR and by 12% for KR.
There was an inevitable drop in the number of surgeries and outpatient clinic visits in the spring and autumn lockdown. With the reorganisation of the orthopaedic service in Slovenia, the number of KR and HR stayed at a relatively high level despite the pandemic. An epidemiological model and mechanisms for the reduction of waiting times could overcome the impact of the epidemic.
本研究的目的是分析新冠疫情对骨科患者医疗保健的影响，即髋关节和膝关节置换手术的数量、90天死亡率、等待时间和门诊就诊次数。
将斯洛文尼亚国家关节成形术登记处2020年疫情期间的髋关节（HR）和膝关节置换（KR）记录与2019年进行比较。为比较翻修原因和90天死亡率，使用了卡方检验。将手术数量和等待时间的中位数与95%置信区间进行比较。门诊就诊次数采用Wilcoxon符号秩和检验。
所有手术数量下降了19%，从7825例降至6335例。初次全髋关节置换手术数量从3530例降至2792例（21%），初次全膝关节置换手术数量从3191例降至2423例（24%）。髋关节翻修手术数量下降了10%，膝关节翻修手术数量下降了25%。我们未发现90天死亡率存在差异（p=0.408）。门诊就诊次数从每年228682次降至196582次（14%）。髋关节置换手术的等待时间增加了15%，膝关节置换手术的等待时间增加了12%。
在春季和秋季封锁期间，手术数量和门诊就诊次数不可避免地下降。尽管疫情肆虐，但随着斯洛文尼亚骨科服务的重新组织，膝关节置换和髋关节置换手术数量仍保持在相对较高水平。一种流行病学模型和减少等待时间的机制可以克服疫情的影响。
