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创伤性脊柱骨折后重返工作岗位:某军队医院的现状。

Returning to Work After Traumatic Spine Fractures: Current Status in a Military Hospital.

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia.

King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia.

出版信息

Mil Med. 2024 Jul 3;189(7-8):e1690-e1695. doi: 10.1093/milmed/usae012.

Abstract

INTRODUCTION

The consequences of traumatic spine fracture (TSF) are complex and have a major burden on patients' social life and financial status. In this study, we aimed to investigate the return to work (RTW) after surgically treated TSFs, develop eventual predictors of delayed or failure to RTW, and assess narcotics use following such injuries.

METHODS

This was a single-center retrospective cohort study that was performed in a tertiary care center. TSF patients who required surgical intervention from 2016 to 2021 were enrolled. Demographic, operative, and complication data, as well as narcotics use, were recorded. RTW was modeled using multivariate logistic regression analysis.

RESULTS

Within the 173 patients with TSF, male patients accounted for 82.7%, and motor vehicle accidents were the most common mechanism of injury (80.2%). Neurologically intact patients represented 59%. Only 38.15% returned to work after their injury. Majority of the patients didn't use narcotics more than 1 week after discharge (93.1%). High surgical blood loss, operation time, and hospital length of stay were significantly associated with not returning to work. In multivariant regression analysis, every increase of 100 ml of surgical blood loss was found to decrease the chance of RTW by 25% (P = 0.04). Furthermore, every increase of one hour in operation time decreases the chance of RTW by 31% (P = 0.03).

CONCLUSION

RTW is an important aspect that needs to be taken into consideration by health care providers. We found that age and high surgery time, blood loss, and hospital stay are significantly impacting patients' RTW after operated TSF.

摘要

简介

创伤性脊柱骨折(TSF)的后果复杂,对患者的社会生活和经济状况造成重大负担。本研究旨在探讨手术治疗 TSF 后的复工情况,确定复工延迟或失败的潜在预测因素,并评估此类损伤后的麻醉药物使用情况。

方法

这是一项单中心回顾性队列研究,在一家三级护理中心进行。纳入 2016 年至 2021 年期间接受手术干预的 TSF 患者。记录人口统计学、手术和并发症数据,以及麻醉药物使用情况。使用多变量逻辑回归分析来模拟复工情况。

结果

在 173 例 TSF 患者中,男性占 82.7%,最常见的损伤机制是机动车事故(80.2%)。神经功能完整的患者占 59%。仅有 38.15%的患者在受伤后复工。大多数患者在出院后 1 周内不使用麻醉药物超过 1 周(93.1%)。较高的手术失血量、手术时间和住院时间与未复工显著相关。多变量回归分析发现,手术失血量每增加 100ml,复工的机会就会减少 25%(P=0.04)。此外,手术时间每增加 1 小时,复工的机会就会减少 31%(P=0.03)。

结论

复工是医疗保健提供者需要考虑的一个重要方面。我们发现,年龄和高手术时间、出血量和住院时间显著影响手术治疗 TSF 后的患者复工情况。

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