美国在 COVID-19 期间谨慎恢复运动医学程序：利用、患者特征和并发症比较。
The Careful Return of Sports Medicine Procedures in the United States During COVID-19: Comparison of Utilization, Patient Demographics, and Complications.
机构信息
From the Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York.
出版信息
J Patient Saf. 2023 Apr 1;19(3):193-201. doi: 10.1097/PTS.0000000000001100. Epub 2022 Dec 13.
OBJECTIVES
Sports medicine procedures encompass some of the highest-volume elective surgeries performed annually. Elective surgery was suspended because of the severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic; therefore, the purpose was to compare temporal trends in procedural volume, patient demographics, and postoperative complications of elective sports medicine procedures in 2019 and 2020.
METHODS
Using a multicenter, nationwide sample, a retrospective query of the 2019 to 2020 American College of Surgeon's National Surgery Quality Improvement Program database was conducted for all patients undergoing common elective sports medicine procedures. Temporal trends in utilization, demographics, and 30-day complications were compared pre-COVID (2019 and 2020Q1) with post-COVID (2020Q2-Q4). Linear regression was used to evaluate changes in procedural volume over time. A significance threshold of P < 0.05 was used.
RESULTS
A total of 48,803 patients underwent elective surgery in 2019 (n = 27,883) and 2020 (n = 20,920), a 25.0% decline. Procedural utilization declined by 42.5% in 2020Q2 and never returned to prepandemic baseline in 2020Q3-Q4. The percentage decline in case volume from 2019 to 2020Q2 was greatest for meniscectomy (47.6%), rotator cuff repair (42.7%), labral repair (41.6%), biceps tenodesis (41.3%), and anterior cruciate ligament reconstruction (38.5%). Total complication rates were similar in 2019 (1.31%) versus 2020 (1.51%; P = 0.072). The 30-day readmission (0.74% versus 0.67%; P = 0.374), reoperation (0.35% versus 0.35%; P = 0.963), and mortality (0.01% versus 0.01%; P = 0.657) rates were similar between calendar years.
CONCLUSIONS
Sports medicine procedures declined during the second quarter of 2020. Despite pandemic restrictions, patients who did undergo surgery did not experience increased complications. The present study may be used by surgeons, hospitals, and subspecialty societies to support the careful utilization of elective surgery during COVID-19.
LEVEL OF EVIDENCE
III, prognostic study.
目的
运动医学手术涵盖了每年进行的一些最高数量的择期手术。由于严重急性呼吸综合征冠状病毒 2（COVID-19）大流行，择期手术已暂停；因此，目的是比较 2019 年和 2020 年择期运动医学手术的程序量、患者人口统计学和术后并发症的时间趋势。
方法
使用多中心、全国性样本，对 2019 年至 2020 年美国外科医师学会国家手术质量改进计划数据库进行回顾性查询，以确定所有接受常见择期运动医学手术的患者。将 COVID 前（2019 年和 2020 年第 1 季度）与 COVID 后（2020 年第 2 季度至第 4 季度）进行比较，以评估随时间推移程序量、人口统计学和 30 天并发症的变化。使用线性回归来评估程序量随时间的变化。使用 P < 0.05 作为显著性阈值。
结果
共有 48803 名患者在 2019 年（n = 27883）和 2020 年（n = 20920）接受择期手术，下降了 25.0%。2020 年第 2 季度手术量下降了 42.5%，2020 年第 3 季度至第 4 季度从未恢复到大流行前的基线水平。2019 年至 2020 年第 2 季度，半月板切除术（47.6%）、肩袖修复术（42.7%）、盂唇修复术（41.6%）、肱二头肌肌腱固定术（41.3%）和前交叉韧带重建术（38.5%）的病例量下降幅度最大。2019 年总并发症率为 1.31%，2020 年为 1.51%（P = 0.072）。30 天再入院率（0.74%对 0.67%；P = 0.374）、再次手术率（0.35%对 0.35%；P = 0.963）和死亡率（0.01%对 0.01%；P = 0.657）在历年之间相似。
结论
运动医学手术在 2020 年第 2 季度下降。尽管存在大流行限制，但接受手术的患者并未出现并发症增加的情况。本研究可被外科医生、医院和专科协会用于支持在 COVID-19 期间谨慎使用择期手术。
证据水平
III，预后研究。
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