Tay Hua-Yong, Wu Wen-Tien, Peng Cheng-Huan, Liu Kuan-Lin, Yu Tzai-Chiu, Chen Ing-Ho, Yao Ting-Kuo, Chang Chia-Ming, Chua Jian-Yuan, Wang Jen-Hung, Yeh Kuang-Ting
Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan.
Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan.
Medicina (Kaunas). 2023 Sep 11;59(9):1640. doi: 10.3390/medicina59091640.
: Hip fractures are associated with mortality and poor functional outcomes. The COVID-19 pandemic has affected patterns of care and health outcomes among fracture patients. This study aimed to determine the influence of COVID-19 infection on hip fracture recovery. : We prospectively collected data on patients with hip fractures who presented at Hualien Tzu Chi Hospital between 9 March 2022 and 9 September 2022. The data included demographic information and functional scores taken before, during, and after surgery. The patients were divided into two groups: COVID-19 (+) and COVID-19 (-). : This study recruited 85 patients, 12 of whom (14.12%) were COVID-19 (+). No significant differences in preoperative or perioperative parameters between the two groups were observed. The postoperative Barthel index score was significantly impacted by COVID-19 infection ( = 0.001). The incidence of postoperative complications was significantly correlated with general anesthesia ( = 0.026) and the length of stay ( = 0.004) in hospital. Poor postoperative functional scores were associated with lower preoperative Barthel index scores ( < 0.001). Male sex ( = 0.049), old age ( = 0.012), a high American Society of Anesthesiologists grade ( = 0.029), and a high Charlson comorbidity index score ( = 0.028) were associated with mortality. : Hip fracture surgeries were not unduly delayed in our hospital during the COVID-19 pandemic, but the patients' postoperative Barthel index scores were significantly influenced by COVID-19 (+). The preoperative Barthel index score may be a good predictive tool for the postoperative functional recovery of these patients.
髋部骨折与死亡率及不良功能结局相关。新冠疫情影响了骨折患者的护理模式和健康结局。本研究旨在确定新冠感染对髋部骨折恢复的影响。
我们前瞻性收集了2022年3月9日至2022年9月9日在花莲慈济医院就诊的髋部骨折患者的数据。数据包括人口统计学信息以及手术前、手术期间和手术后的功能评分。患者被分为两组:新冠病毒阳性组和新冠病毒阴性组。
本研究招募了85名患者,其中12名(14.12%)为新冠病毒阳性。两组术前或围手术期参数未观察到显著差异。新冠感染对术后巴氏指数评分有显著影响(P = 0.001)。术后并发症的发生率与全身麻醉(P = 0.026)和住院时间(P = 0.004)显著相关。术后功能评分差与术前巴氏指数评分低相关(P < 0.001)。男性(P = 0.049)、高龄(P = 0.012)、美国麻醉医师协会分级高(P = 0.029)和查尔森合并症指数评分高(P = 0.028)与死亡率相关。
在新冠疫情期间,我院髋部骨折手术未过度延迟,但新冠病毒阳性对患者术后巴氏指数评分有显著影响。术前巴氏指数评分可能是这些患者术后功能恢复的良好预测工具。