Zarcos-Paredes Irene, Matellanes-Mielgo Irene, Ordas-Bayon Alejandro
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Ramón y Cajal, M-607, 9, 100, 28034, Madrid, Spanien.
Orthopadie (Heidelb). 2024 Sep;53(9):677-681. doi: 10.1007/s00132-024-04529-z. Epub 2024 Jul 23.
Trauma secondary to extreme weather events may heavily impact the normal activity of orthopaedic surgery departments, especially in places not prepared to deal with them. The Filomena snowstorm, which happened in January 2021, was one of the greatest snowstorms ever in Spain. During it, the constant influx of trauma patients caused Orthopaedic Emergencies Department (OED) to collapse. The primary objective of this study was to describe the orthopaedic injuries and changes in fracture's epidemiology observed during this exceptional period. Secondary objectives were to analyse the collected variables in order to minimize the future impact of these unexpected extreme weather events.
A retrospective cohort study between patients that came to the OED during the snowstorm (Filomena group) and those who came on the same period of the previous year (Control group) was made. The following data were collected: age, sex, injury location, injury mechanism, diagnosis, AO/OTA fracture classification, treatment type (conservative vs surgical) and delay of surgical treatment.
A total of 1237 patients were included, 655 patients from the Filomena group and 582 from the Control group. One in two patients in the Filomena group sustained a fracture (50.7% vs 23.2%). The most frequent diagnosis on the Filomena group was distal radius fracture (16.2%), which was five times more frequent than in the Control group (3.4%). A significant increment was also observed in the incidence of ankle (21.7%) and proximal humerus (33%) fractures. In the Filomena group, surgically treated fractures increased by 168%, being more severe, as C‑type fractures were more prevalent (23% vs 13%). Mean delay to surgery was 6.78 days during the snowstorm.
Unexpected snowstorms entail an exponential rise in orthopaedic care demand and OED pressures. A significant increment in orthopaedic trauma surgery, up to 168% more, particularly distal radius, proximal humerus and ankle fractures, is to be expected, which will imply elective surgery cancellation, hurting patients and increasing costs.
极端天气事件导致的创伤可能会严重影响骨科手术科室的正常工作，尤其是在那些没有做好应对准备的地区。2021年1月发生的“菲洛梅娜”暴风雪是西班牙有史以来最严重的暴风雪之一。在此期间，创伤患者不断涌入，导致骨科急诊科不堪重负。本研究的主要目的是描述在这一特殊时期观察到的骨科损伤情况以及骨折流行病学的变化。次要目的是分析收集到的变量，以尽量减少这些意外极端天气事件对未来的影响。
对暴风雪期间前往骨科急诊科的患者（“菲洛梅娜”组）和上一年同期前来就诊的患者（对照组）进行了一项回顾性队列研究。收集了以下数据：年龄、性别、损伤部位、损伤机制、诊断、AO/OTA骨折分类、治疗类型（保守治疗与手术治疗）以及手术治疗延迟时间。
共纳入1237例患者，其中“菲洛梅娜”组655例，对照组582例。“菲洛梅娜”组每两名患者中就有一人发生骨折（50.7%对23.2%）。“菲洛梅娜”组最常见的诊断是桡骨远端骨折（16.2%），其发生率是对照组（3.4%）的五倍。踝关节（21.7%）和肱骨近端（33%）骨折的发生率也显著增加。在“菲洛梅娜”组，接受手术治疗的骨折增加了168%，且更为严重，因为C型骨折更为普遍（23%对13%）。暴风雪期间手术的平均延迟时间为6.78天。
意外的暴风雪会使骨科护理需求和骨科急诊科压力呈指数级上升。预计骨科创伤手术将显著增加，增幅高达168%，尤其是桡骨远端、肱骨近端和踝关节骨折，这将意味着择期手术取消，损害患者利益并增加成本。
