Nanapragasam Andrew, White Lawrence M
Department of Medical Imaging, University of Toronto, Toronto, ON M5G 2C4, Canada.
BJR Open. 2024 Aug 22;6(1):tzae016. doi: 10.1093/bjro/tzae016. eCollection 2024 Jan.
To evaluate the incidence and spectrum of findings in patients referred for CT imaging of extremity soft tissue infection in the adult emergency department (ED) setting before and during the COVID-19 pandemic.
Two hundred thirteen CT exams in the pre-COVID cohort (February 1, 2018-January 31, 2020) and 383 CT exams in the COVID cohort (February 1, 2020-January 31, 2022) were evaluated in this multicentre, retrospective study. Demographic information and clinical histories were collected, along with regional data on COVID-19 hospitalizations and deaths.
Comparable age and sex distribution was found in the pre-COVID (average age of 53.5 years; male: female ratio of 71:29) and COVID (average age of 54.6 years; male: female ratio of 69:31) cohorts. The frequency of reported clinical risk factors (diabetes mellitus, injected drug use, prior surgery, animal bite) was not significantly different between the two cohorts. Findings of simultaneous involvement of both superficial and deep soft tissue infection on CT imaging were significantly higher in the COVID cohort (53.4%) than in the pre-COVID cohort (33.7%). CT findings of phlegmon (49.1% vs 22.1%), ulcers (48.8% vs 30%), osteomyelitis (21.7% vs 13.1%), as well as localized (18.8% vs 11.7%) and extensive (3.7% vs 2.3%) soft tissue gas were significantly more common in the COVID cohort than in the pre-COVID cohort.
During the COVID-19 pandemic, the number of ED CT exams for the evaluation of extremity soft tissue infection increased, with this imaging also showing more advanced disease. Pandemic-related modifications to human behaviour and re-distribution of healthcare resources may underlie these observed changes.
This multi-centre study shows an increase in extremity soft tissue infection presenting to the ED during the pandemic. This finding is important for future pandemic preparations, as it can aid in the decision-making process around resource allocation.
评估在成人急诊科（ED）环境中，2019冠状病毒病（COVID-19）大流行之前及期间，因肢体软组织感染接受CT成像检查的患者中各种检查结果的发生率及范围。
在这项多中心回顾性研究中，对COVID-19之前队列（2018年2月1日至2020年1月31日）的213例CT检查和COVID队列（2020年2月1日至2022年1月31日）的383例CT检查进行了评估。收集了人口统计学信息和临床病史，以及关于COVID-19住院和死亡的地区数据。
在COVID-19之前队列（平均年龄53.5岁；男女比例为71:29）和COVID队列（平均年龄54.6岁；男女比例为69:31）中发现了相似的年龄和性别分布。两个队列中报告的临床危险因素（糖尿病、注射吸毒、既往手术、动物咬伤）的频率没有显著差异。COVID队列中CT成像显示浅表和深部软组织同时感染的情况（53.4%）显著高于COVID-19之前队列（33.7%）。COVID队列中蜂窝织炎（49.1%对22.1%）、溃疡（48.8%对30%）、骨髓炎（21.7%对13.1%）以及局限性（18.8%对11.7%）和广泛性（3.7%对2.3%）软组织积气的CT表现明显比COVID-19之前队列更常见。
在COVID-19大流行期间，用于评估肢体软组织感染的急诊CT检查数量增加，且这种成像显示的疾病也更严重。与大流行相关的人类行为改变和医疗资源重新分配可能是这些观察到的变化的原因。
这项多中心研究表明，大流行期间急诊科中肢体软组织感染的病例有所增加。这一发现对未来的大流行准备工作很重要，因为它有助于围绕资源分配的决策过程。
