Comparative Characteristics of Patients Structure in the Orthopedics Department of a Clinical Hospital in a Region Remote from the Front Line during Peacetime and the First Year of a Full-Scale War in Ukraine

Abstract

Objective. To analyze changes in the nosological structure of patients, treatment technologies, to outline the peculiarities of surgical interventions in the trauma profile of a civilian clinical hospital during the war period and to emphasize the need for relevant knowledge and skills of specialists in the treatment of combat trauma and its consequences.Methods. A comparative analysis of the clinical and nosological structure of 2,475 patients were treated during the year before the war and 3,838 patients during the full-scale war year. Among them, 83.1 % were civilians, 7.7 % were temporarily resettled, and 9.2 % were military personnel. The study utilized bibliosemantic, medical-statistical, and clinical methods. Results. During the active phase of the war, the Orthopedics Department of the civilian clinical hospital provided specialized medical assistance to both civilian populations and military personnel injured during hostilities. The relative number of hospitalized men increased by 4.83 %, and although the absolute number of those urgently hospitalized decreased. Despite the overall increase in the number of operations per patient, surgical activity in the Orthopedics Department decreased from 86 to 80 %. The intensification of inpatient treatment organization, patient preparation for subsequent stages of surgical interventions in the Rehabilitation Department, and outpatient medicine work collectively reduced the average bed-day in the Orthopedics Department by 12.3 %. Conclusions. Thus, during the war, the structure of patients in the Orthopedics Department of the civilian medical clinical institution changed, with an increase in the relative number of male patients and those with multiple and combined injuries. A notable feature of the treatment process organization during hostilities is the phasing of the treatment of the wounded not only at the levels of medical evacuation but also within the clinical hospital. The intensification of the organizational component and the outpatient link of the treatment process allowed for a reduction in bed-days and the provision of inpatient treatment to a larger number of patients.