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新冠病毒病对纽约市一家三级医疗中心肩关节置换术的影响。

Effect of COVID-19 on Shoulder Arthroplasty at a Tertiary Care Medical Center in New York City.

作者信息

Wang Kevin C, Patel Akshar V, White Christopher A, Gross Benjamin D, Parsons Bradford O, Cagle Paul J

机构信息

Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, New York City, New York, Estados Unidos.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Oct 25;58(1):121-126. doi: 10.1055/s-0041-1735950. eCollection 2023 Feb.

Abstract

The COVID-19 pandemic led to an unprecedented pause in elective surgeries, including shoulder arthroplasty. We sought to determine whether clinical and/or demographic differences would be seen between patients who presented for shoulder arthroplasty during the pandemic compared with the previous year (2019).  Institutional records were queried for patients who underwent shoulder replacement between March 1 and July 1 of 2019 and 2020. Demographics, range of motion, surgical duration, hospitalization time, discharge disposition, and postoperative management were analyzed.  The mean duration of surgery was 160 ± 50 minutes in 2020 and 179 ± 54 minutes in 2019 (  = 0.13). The mean hospitalization time was 36 ± 13 hours in 2020 and 51 ± 40 hours in 2019 (  = 0.04). In 2019, 96% of the patients participated in physical therapy, while 71% did it in 2020 (  = 0.003). A total of 100% of the 2019 patients and 86% of the 2020 patients participated in an in-person postoperative follow-up (  = 0.006). The 2019 patients reported for an office visit on average 14 ± 11 days after surgery; the 2020 patients waited 25 ± 25 days to return for a follow-up (  = 0.10). Range of motion, age, American Society of Anesthesiologists (ASA) scores, and complication rates did not differ between the cohorts.  Patients presenting for surgery during the initial phase of the pandemic were demographically and clinically similar to 2019 patients. However, the length of stay was significantly reduced during the COVID-19 pandemic. Postoperative follow-up and physical therapy were delayed in 2020, but this did not lead to differences in complication or readmission rates compared with those of the 2019 cohort.  III.

摘要

新冠疫情导致包括肩关节置换术在内的择期手术出现了前所未有的暂停。我们试图确定在疫情期间接受肩关节置换术的患者与上一年(2019年)的患者相比,是否会出现临床和/或人口统计学差异。

查询了2019年和2020年3月1日至7月1日期间接受肩关节置换术患者的机构记录。分析了人口统计学、活动范围、手术时长、住院时间、出院处置及术后管理情况。

2020年手术的平均时长为160±50分钟,2019年为179±54分钟(P = 0.13)。2020年的平均住院时间为36±13小时,2019年为51±40小时(P = 0.04)。2019年,96%的患者接受了物理治疗,而2020年这一比例为71%(P = 0.003)。2019年的患者中有100%、2020年的患者中有86%参加了术后面对面随访(P = 0.006)。2019年的患者术后平均14±11天进行门诊复诊;2020年的患者等待25±25天进行随访(P = 0.10)。各队列之间的活动范围、年龄、美国麻醉医师协会(ASA)评分及并发症发生率无差异。

在疫情初期接受手术的患者在人口统计学和临床上与2019年的患者相似。然而,在新冠疫情期间住院时间显著缩短。2020年术后随访和物理治疗有所延迟,但与2019年队列相比,这并未导致并发症或再入院率出现差异。

III.

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