Jankovic Dragan, Krenzlin Harald, Keric Naureen, Ottenhausen Malte
Department of Neurosurgery, University Medical Center, Mainz, Germany.
Front Surg. 2023 Jan 17;9:1086960. doi: 10.3389/fsurg.2022.1086960. eCollection 2022.
Over the past two years during the pandemic, the German health system has taken drastic measures, like the continuous use of face masks for all staff, restrictions of hospital visits as well as cancellation of elective surgical procedures. As a potential side effect of these measures, a significant reduction of surgical site infections was reported for neurosurgical patients. The purpose of our study was to analyze the impact of these measures on spinal surgery.
We performed a retrospective analysis to compare patient samples, procedures and infection rates before (January 2019 - March 2020) and during (April 2020 - June 2021) the pandemic to evaluate the impact of the measures mentioned above. Demographic and clinical data were collected and correlated with the occurrence of postoperative complications, especially infection.
Our analysis showed no relevant decrease of spine surgeries (838 surgeries in non-pandemic group vs. 831 surgeries pandemic group). The most common postoperative complication was wound infection in both groups, followed by urinary tract infection and pneumonia. In both patient groups, infections were more prevalent in surgeries of multilevel posterior instrumentation. Comparing the two groups of patients, a slight, non-significant (0.5%) reduction of overall postoperative complications in the pandemic group was observed. However, the number of spinal surgeries classified as emergencies in our institution increased by 10.2% during the last 15 months of the COVID-19 pandemic. In line with this finding the urgent transfer of patients from smaller hospitals increased by 14.2%, compared to previous years.
The volume of spinal surgeries remained high and complication rates stable during the pandemic. A reason why complication rates did not drop as reported previously might be a significant change in patient sample due to the increase of emergency surgeries. A decrease of complication rates, especially infections by the measures of infection prevention for the pandemic was not observed.
在过去两年的疫情期间，德国医疗系统采取了严厉措施，如全体医护人员持续佩戴口罩、限制医院探视以及取消择期手术。作为这些措施的潜在副作用，据报道神经外科患者的手术部位感染显著减少。我们研究的目的是分析这些措施对脊柱手术的影响。
我们进行了一项回顾性分析，以比较疫情前（2019年1月至2020年3月）和疫情期间（2020年4月至2021年6月）的患者样本、手术及感染率，以评估上述措施的影响。收集了人口统计学和临床数据，并将其与术后并发症尤其是感染的发生情况相关联。
我们的分析显示脊柱手术数量没有显著减少（非疫情组838例手术，疫情组831例手术）。两组中最常见的术后并发症均为伤口感染，其次是尿路感染和肺炎。在两组患者中，感染在多级后路内固定手术中更为普遍。比较两组患者，疫情组术后总体并发症略有减少，但不显著（0.5%）。然而，在新冠疫情的最后15个月里，我们机构中列为急诊的脊柱手术数量增加了10.2%。与这一发现一致的是，与前几年相比，从小医院紧急转诊的患者增加了14.2%。
疫情期间脊柱手术量保持高位，并发症发生率稳定。并发症发生率未如先前报道那样下降的一个原因可能是急诊手术增加导致患者样本发生了显著变化。未观察到因疫情防控措施而使并发症发生率尤其是感染率下降。
