Department of Neurosurgery, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Republic of Korea.
Department of Neurosurgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, Republic of Korea.
PLoS One. 2024 Jun 11;19(6):e0305128. doi: 10.1371/journal.pone.0305128. eCollection 2024.
During the first year of the COVID-19 pandemic, the Republic of Korea (ROK) experienced three epidemic waves in February, August, and November 2020. These waves, combined with the overarching pandemic, significantly influenced trends in spinal surgery. This study aimed to investigate the trends in degenerative lumbar spinal surgery in ROK during the early COVID-19 pandemic, especially in relation to specific epidemic waves. Using the National Health Information Database in ROK, we identified all patients who underwent surgery for degenerative lumbar spinal diseases between January 1, 2019 and December 31, 2020. A joinpoint regression was used to assess temporal trends in spinal surgeries over the first year of the COVID-19 pandemic. The number of surgeries decreased following the first and second epidemic waves (p<0.01 and p = 0.34, respectively), but these were offset by compensatory increases later on (p<0.01 and p = 0.05, respectively). However, the third epidemic wave did not lead to a decrease in surgical volume, and the total number of surgeries remained comparable to the period before the pandemic. When compared to the pre-COVID-19 period, average LOH was reduced by 1 day during the COVID-19 period (p<0.01), while mean hospital costs increased significantly from 3,511 to 4,061 USD (p<0.01). Additionally, the transfer rate and the 30-day readmission rate significantly decreased (both p<0.01), while the reoperation rate remained stable (p = 0.36). Despite the impact of epidemic waves on monthly surgery numbers, a subsequent compensatory increase was observed, indicating that surgical care has adapted to the challenges of the pandemic. This adaptability, along with the stable total number of operations, highlights the potential for healthcare systems to continue elective spine surgery during public health crises with strategic resource allocation and patient triage. Policies should ensure that surgeries for degenerative spinal diseases, particularly those not requiring urgent care but crucial for patient quality of life, are not unnecessarily halted.
在 COVID-19 大流行的第一年，韩国（ROK）在 2020 年 2 月、8 月和 11 月经历了三波疫情。这些波次与总体大流行一起，对脊柱手术趋势产生了重大影响。本研究旨在调查 COVID-19 大流行早期 ROK 退行性腰椎脊柱手术的趋势，特别是与特定疫情波次的关系。我们使用韩国国家健康信息数据库，确定了 2019 年 1 月 1 日至 2020 年 12 月 31 日期间因退行性腰椎脊柱疾病接受手术的所有患者。采用 joinpoint 回归评估 COVID-19 大流行第一年脊柱手术的时间趋势。第一次和第二次疫情波次后手术数量减少（p<0.01 和 p = 0.34），但后来出现了补偿性增加（p<0.01 和 p = 0.05）。然而，第三次疫情波次并未导致手术量减少，手术总数与大流行前相当。与 COVID-19 前时期相比，COVID-19 期间平均 LOS 减少了 1 天（p<0.01），而平均住院费用从 3511 美元显著增加到 4061 美元（p<0.01）。此外，转移率和 30 天再入院率显著降低（均 p<0.01），而再次手术率保持稳定（p = 0.36）。尽管疫情波次对每月手术数量有影响，但随后观察到补偿性增加，表明手术护理已适应大流行的挑战。这种适应性以及稳定的手术总数突显了医疗保健系统在公共卫生危机期间通过战略性资源分配和患者分诊继续进行择期脊柱手术的潜力。政策应确保退行性脊柱疾病手术，特别是那些不需要紧急护理但对患者生活质量至关重要的手术，不会不必要地停止。
BMC Infect Dis. 2021-5-26
J Korean Neurosurg Soc. 2022-9
Spine (Phila Pa 1976). 2007-9-1
BMC Musculoskelet Disord. 2021-7-10
Neurospine. 2023-3
Neurospine. 2023-3
Medicina (Kaunas). 2022-9-21
Zotero 插件