新冠疫情封锁是否改变了老年人脆性骨折的发生率和治疗方法？法国某大学附属医院的病例对照研究。

Has the COVID lockdown altered the incidence and management of fragility fractures in older adults? Case-control study at a French University Hospital.

机构信息

Service d'orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France.

出版信息

Orthop Traumatol Surg Res. 2023 Feb;109(1):103419. doi: 10.1016/j.otsr.2022.103419. Epub 2022 Sep 24.

DOI:10.1016/j.otsr.2022.103419

PMID:36167250

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9508702/

Abstract

INTRODUCTION

In France, a national lockdown related to the COVID-19 pandemic was imposed from March 17 to May 11, 2020, drastically changing our professional and organizational practices. We were interested on the impact of the lockdown on fragility fractures in older adults (65 years and older). The primary objective of this study was to evaluate the incidence of peripheral and pelvic fragility fractures during the lockdown. The secondary objectives were to carry out an epidemiological analysis of the fractures, treatments and hospitalization data.

HYPOTHESIS

The main hypothesis was that the number of peripheral and pelvic fragility fractures was lower during the lockdown in 2020 than in the same (non-lockdown) period in 2019.

MATERIALS AND METHODS

We retrospectively collected epidemiological (age, sex), clinical (type of fracture, treatment) and hospitalization data from patients 65 years and older who came to the emergency room because of a peripheral and/or pelvic fracture between March 17 and May 11 of the years 2019 and 2020.

RESULTS

We included 192 patients in 2019 and 157 patients in 2020. The mean age and sex ratio were not statistically different. The number of peripheral and/or pelvic fragility fractures decreased by 16%. The share of patients treated surgically was similar in both years (46% in 2019; 51% in 2020 (p=0.47)). The number of proximal femur fractures dropped by 21%. The mean time to surgery for these fractures was shorter in 2020 (p=0.02) although the mean length of hospital stay was unchanged (p=0.72) The mortality rate of patients hospitalized for fragility fractures did not increase significantly (p=0.51).

DISCUSSION

We observed a reduction in the number of peripheral and pelvic fragility fractures in patients 65 years and older during the lockdown. To ensure that we met our goals of optimal care for proximal femur fractures, a general reorganization of the operating room was necessary. The continued availability of fully functional technical facilities despite this health crisis was crucial to being able to treat these fractures and to prevent increased mortality.

LEVEL OF EVIDENCE

III, case-control study.

摘要

引言

在法国，与 COVID-19 大流行相关的全国封锁于 2020 年 3 月 17 日至 5 月 11 日实施，这极大地改变了我们的专业和组织实践。我们对封锁对老年人（65 岁及以上）脆弱性骨折的影响感兴趣。本研究的主要目的是评估封锁期间外周和骨盆脆弱性骨折的发生率。次要目标是对骨折、治疗和住院数据进行流行病学分析。

假设

主要假设是 2020 年封锁期间外周和骨盆脆弱性骨折的数量低于 2019 年同期（非封锁期间）。

材料和方法

我们回顾性地收集了 2019 年 3 月 17 日至 5 月 11 日期间因外周和/或骨盆骨折而到急诊室就诊的 65 岁及以上患者的流行病学（年龄、性别）、临床（骨折类型、治疗）和住院数据。2019 年和 2020 年。

结果

我们纳入了 192 名 2019 年患者和 157 名 2020 年患者。平均年龄和性别比无统计学差异。外周和/或骨盆脆弱性骨折的数量减少了 16%。两种年份的手术治疗比例相似（2019 年为 46%；2020 年为 51%（p=0.47））。股骨近端骨折的数量减少了 21%。这些骨折的手术时间在 2020 年缩短（p=0.02），尽管住院时间保持不变（p=0.72）。因脆弱性骨折住院的患者死亡率没有显著增加（p=0.51）。