Department of Orthopaedic Surgery, University of California San Diego, 9500 Gilman Drive MC0863, La Jolla, CA 92037, USA.
Int J Environ Res Public Health. 2022 Aug 25;19(17):10573. doi: 10.3390/ijerph191710573.
The study objective is to characterize the impact of COVID-19 related hospital administrative restrictions on patient demographics, surgical care, logistics, and patient outcomes in spine surgery. This was a retrospective study of 331 spine surgery patients at UCSD conducted during 1 March 2019-31 May 2019 (pre-COVID-19) and 1 March 2020-31 May 2020 (first COVID-19 surge). All variables were collected through RedCap and compared between pre- and during-COVID groups. There were no significant differences in patient demographics, operating room duration, and skin-to-skin time. However, length of stay was 4.7 days shorter during COVID-19 ( = 0.03) and more cases were classified as 'urgent' ( = 0.04). Preoperative pain scores did not differ between groups ( = 0.51). However, pain levels at discharge were significantly higher during COVID ( = 0.04) and trended towards remaining higher in the short- ( = 0.05) but not long-term ( = 0.17) after surgery. There was no significant difference in the number of post-operative complications, but there was an increase in the use of the emergency room and telemedicine to address complications when they arose. Overall, the pandemic resulted in a greater proportion of 'urgent' spine surgery cases and shorter length of hospital stay. Pain levels upon discharge and at short-term timepoints were higher following surgery but did not persist in the long term.
本研究旨在探讨 COVID-19 相关医院行政限制对脊柱手术患者人群统计学特征、手术护理、后勤和患者结局的影响。这是一项在加州大学圣地亚哥分校进行的回顾性研究，纳入了 2019 年 3 月 1 日至 5 月 31 日（COVID-19 前）和 2020 年 3 月 1 日至 5 月 31 日（第一波 COVID-19 疫情期间）期间的 331 例脊柱手术患者。所有变量均通过 RedCap 收集，并在 COVID-19 前组和 COVID-19 期间组之间进行比较。两组患者的人群统计学特征、手术室时间和皮肤到皮肤时间无显著差异。然而，COVID-19 期间的住院时间缩短了 4.7 天（ = 0.03），更多的病例被归类为“紧急”（ = 0.04）。术前疼痛评分在两组间无差异（ = 0.51）。然而，COVID 期间出院时的疼痛水平显著升高（ = 0.04），且在短期（ = 0.05）而非长期（ = 0.17）后仍有升高趋势。术后并发症的数量无显著差异，但在出现并发症时，急诊室和远程医疗的使用有所增加。总体而言，大流行导致更多的“紧急”脊柱手术病例和更短的住院时间。手术后出院时和短期时间点的疼痛水平较高，但在长期内并未持续。
