Yu Justin, Joshi Jai, Wong Carmen, Ahmed Nafis, Rao Amit, Li Timmy, Al Rubaiay Ammar, Landis Gregg, Oropallo Alisha
Resident Physician, Department of Surgery, Zucker School of Medicine at Hoftsra/Northwell, Hempstead, NY.
Department of Surgery, Comprehensive Wound Healing & Hyperbaric Center, Northwell Health, Lake Success, NY.
Wound Manag Prev. 2023 Mar;69(1):49-57.
In March 2020, due to the COVID-19 pandemic, hospitalizations in New York state were restricted to emergency purposes. Non-COVID related cases involving lower extremity wounds were only admitted for acute infections and limb salvage. Patients with these conditions were placed at higher risk for eventual limb loss.
To understand the impact of COVID-19 on amputation rates.
A retrospective review of lower limb institution-wide amputations was conducted at Northwell Health from January 2020 to January 2021. The amputation rates during the COVID-19 shutdown period were compared to the pre-pandemic, post-shutdown, and reopening period.
The pre-pandemic period had 179 amputations, of which 8.38 % were proximal. 86 amputations were performed during shutdown, with a greater proportion being proximal (25.58 %, p=0.0009). Following the shutdown period, amputations returned to baseline. The proportion of proximal amputations during post-shutdown was 18.5 % and during reopening was 12.06 %. Patients had 4.89 times higher odds of undergoing a proximal amputation during the shutdown period.
The effect of COVID-19 on amputation rates demonstrates an increase in proximal amputation during the initial shutdown. This study suggests an indirect negative effect of COVID-19 hospital restrictions on surgeries during the initial shutdown period.
2020年3月，由于新冠疫情，纽约州的住院治疗仅限于紧急情况。与新冠无关的下肢伤口病例仅因急性感染和肢体挽救而入院。患有这些疾病的患者最终肢体丧失的风险更高。
了解新冠疫情对截肢率的影响。
对2020年1月至2021年1月在诺斯韦尔健康中心进行的全机构范围内的下肢截肢手术进行回顾性研究。将新冠疫情封锁期间的截肢率与疫情前、封锁后和重新开放期间的截肢率进行比较。
疫情前有179例截肢手术，其中8.38%为近端截肢。封锁期间进行了86例截肢手术，近端截肢的比例更高（25.58%，p=0.0009）。封锁期过后，截肢率恢复到基线水平。封锁后近端截肢的比例为18.5%，重新开放期间为12.06%。在封锁期间，患者接受近端截肢的几率高出4.89倍。
新冠疫情对截肢率的影响表明，在最初的封锁期间近端截肢有所增加。这项研究表明，新冠疫情期间医院的限制措施在最初的封锁期对手术产生了间接的负面影响。
