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大流行对关节置换患者功能结局的影响:一项观察性研究。

The impact of the pandemic on functional outcomes for joint replacement patients: An observational study.

机构信息

IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30395. doi: 10.1097/MD.0000000000030395.

Abstract

Elective surgeries, as joint replacement, were resumed after the first COVID-19 pandemic wave in 2020 and a phase of coexistence with the virus began. Surgery was organized in a new way that incorporated procedures aimed at reducing the risk of spreading the virus. The aim of this study is to describe the early functional results for patients undergoing hip and knee replacements at the time healthcare services were being reopened and to compare them with the same outcomes recorded in the prepandemic period. This is a controlled retrospective study. All patients consecutively admitted during 2020 and who underwent hip and knee replacement were enrolled in the study. Patient records from January to March 2020 constituted the prepandemic control group, while patient records from May to December 2020 constituted the study group. Functional recovery was described through the patient's ability to walk using antebrachial devices and to climb up and down 3 steps. The day after surgery on which these activities were first performed was also recorded. The prepandemic group consisted of 183 patients and the pandemic group of 280 patients. The mean age of patients was 66 years (±13.1), female was 44.9% and hip replacement was 66.5%. The number of patients who climbed stairs and the timing thereof was comparable for the 2 groups (68.5% vs 72.2%, respectively; P = .403). There was no significant difference in the incidence of patients able to walk with antebrachial device and incidence of pressure ulcers and major complications. Multivariate analysis confirmed that the incidence of stair climbing was not associated with the prepandemic or pandemic inclusion. During the reopening of orthopedic surgery activity, the reorganization and treatment pathway did not affect the functional outcome achieved by patients underwent joint replacement. Constant monitoring of the functional outcomes will be required so as to further increase the number of joint replacement surgeries.

摘要

择期手术,如关节置换术,在 2020 年第一波 COVID-19 大流行后恢复,开始与病毒共存阶段。手术以新的方式组织,纳入旨在降低病毒传播风险的程序。本研究旨在描述在医疗服务重新开放时接受髋关节和膝关节置换术的患者的早期功能结果,并将其与大流行前记录的相同结果进行比较。这是一项对照回顾性研究。所有在 2020 年连续入院并接受髋关节和膝关节置换术的患者均纳入研究。2020 年 1 月至 3 月的患者记录构成大流行前对照组,而 2020 年 5 月至 12 月的患者记录构成研究组。通过患者使用前臂装置行走和上下 3 级楼梯的能力来描述功能恢复。还记录了首次进行这些活动的手术后的第二天。大流行前组包括 183 名患者,大流行组包括 280 名患者。患者的平均年龄为 66 岁(±13.1),女性为 44.9%,髋关节置换术为 66.5%。两组患者上下楼梯的人数和时间相似(分别为 68.5%和 72.2%;P=0.403)。能够使用前臂装置行走的患者和压疮及主要并发症的发生率无显著差异。多变量分析证实,上下楼梯的发生率与大流行前或大流行期间的纳入无关。在骨科手术活动重新开放期间,重组和治疗途径并未影响接受关节置换术患者的功能结果。需要持续监测功能结果,以进一步增加关节置换手术的数量。

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