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比较 COVID-19 大流行前后行脊柱手术患者的凝血功能和血栓栓塞事件。

Comparison of coagulation profile and thromboembolic events among patients undergoing spinal surgery before and after COVID-19 pandemic.

机构信息

Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Eur Spine J. 2023 Jul;32(7):2288-2292. doi: 10.1007/s00586-023-07688-3. Epub 2023 Apr 4.

DOI:10.1007/s00586-023-07688-3
PMID:37014435
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10071248/
Abstract

BACKGROUND

Impairment of coagulation parameters and increased rate of thromboembolism are known complications of COVID-19 infection. In this study the coagulation profile and rate of thromboembolic events between two groups of patients who underwent spinal surgery before and after the COVID-19 pandemic was compared.

PATIENTS AND METHOD

Clinically and laboratory negative for COVID-19 elective patients before (n: 211) and during COVID- 19 pandemic (n: 294) with spinal surgeries were included in this retrospective study. Surgical characteristics, Physiologic parameters, coagulation parameters and thromboembolic events were compared between the two study groups.

RESULTS

Preoperative coagulation parameters, including PT, PTT, and INR were significantly increased during the COVID-19 pandemic (P < 0.001. P = 0.001, and P < 0.001, respectively), while the platelet count was significantly reduced (P = 0.04). The same differences were observed between the two study groups after the spinal surgery. In addition, respiratory rate and postoperative bleeding of the first postoperative 24 h was significantly more in patients who were operated on during COVID-19 outbreak (P = 0.03 and P = 0.002, respectively). The rate of thromboembolic events was 3.1% during the COVID-19 pandemic (seven PE, one DVT, and one MI) and 0% before that. This difference was statistically significant (P = 0.043).

CONCLUSION

The rate of thromboembolic events seems to be increased during the COVID-19 pandemic. These findings urge more stringent monitoring of the patients' coagulation parameters during the COVID-19 outbreak.

摘要

背景

凝血参数的损伤和血栓栓塞率的增加是 COVID-19 感染的已知并发症。在这项研究中,比较了 COVID-19 大流行前后两组接受脊柱手术的患者的凝血谱和血栓栓塞事件发生率。

患者和方法

这项回顾性研究纳入了临床和实验室均未感染 COVID-19 的择期接受脊柱手术的患者(大流行前组:211 例;大流行期间组:294 例)。比较了两组患者的手术特征、生理参数、凝血参数和血栓栓塞事件。

结果

COVID-19 大流行期间,术前凝血参数(PT、PTT 和 INR)显著升高(P<0.001、P=0.001 和 P<0.001),而血小板计数显著降低(P=0.04)。两组患者在脊柱手术后也观察到了同样的差异。此外,COVID-19 大流行期间手术患者的呼吸频率和术后 24 小时内的首次出血显著增加(P=0.03 和 P=0.002)。COVID-19 大流行期间血栓栓塞事件的发生率为 3.1%(7 例肺栓塞、1 例深静脉血栓形成和 1 例心肌梗死),而大流行前为 0%。这种差异具有统计学意义(P=0.043)。

结论

在 COVID-19 大流行期间,血栓栓塞事件的发生率似乎增加。这些发现敦促在 COVID-19 爆发期间更严格地监测患者的凝血参数。