在首次受SARS-CoV-2大流行轻度影响的地区,全面系统封锁对急诊骨科和肢体创伤手术的有限影响:一项多中心研究(在受SARS-CoV-2大流行轻度影响的地区,封锁效果有限)

G. Villatte
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引用次数: 0

摘要

目的:SARS-CoV-2大流行导致许多国家对人口进行系统性封锁,同时对医疗系统进行重组,以应对这一前所未有的卫生危机。本研究确定了(i)在受SARS-CoV-2大流行轻微影响的法国某地区封锁期间进行的紧急外科手术数量,以及(ii)相关手术类型(主要特征)。方法:回顾性、比较、观察、多中心研究急诊骨科和肢体创伤手术在封锁期间进行。它包括三个参考护理中心,其中两个是教学医院。并与2019年同期数据进行了比较。对于每位患者,收集以下数据:手术日期、年龄、性别、居住地、用于对损伤进行解剖分类的标准化描述符、损伤发生的背景以及SARS-CoV-2 PCR状态。结果:2019年同期,1098例患者接受了手术,1266例患者接受了手术,差异无统计学意义,为- 13.3% (p = 0.11)[第13周为- 39.2% (p = 0.02),第19周为+7.6% (p = 0.16)]。除了手部和腕部的骨损伤(+13.4%,p = 0.07)外,所有解剖部位的活动度均下降,尤其是桡骨远端(- 55.8%,p = 0.001)和踝关节(- 40.5%,p = 0.01)。伤害发生的环境发生了变化,特别是运动事故(- 80.0%,p < 0.001)和道路交通事故(- 41.8%,p = 0.04)的数量显著减少,DIY和园艺事故(+62.7%,p < 0.001)的数量增加。结论:在受疫情影响较轻的地区,急诊手术的减少幅度要小得多。当全球卫生危机来袭时,必须在当地调整为确保人口所需护理的连续性制定方法的卫生政策。证据水平:4 -描述性流行病学研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Limited Effect of Generalized Systematic Lockdown on Urgent Orthopedic and Limb Trauma Surgery in a Geographical Area Mildly Affected by the First of SARS-CoV-2 Pandemic: A Multicentric Study (Limited Effect of Lockdown in an Area Mildly affected by the Pandemic)
Purpose: The SARS-CoV-2 pandemic led to a systematic lockdown of populations in many countries along with the reorganization of care systems to respond to this unprecedented health crisis. This study determined (i) the number of urgent surgical operations carried out during the lockdown in a region of France mildly affected by the SARS-CoV-2 pandemic, and (ii) the types of surgery concerned (main characteristics). Methods: A retrospective, comparative, observational, multicentric study of urgent orthopedic and limb trauma surgery during lockdown was conducted. It included three reference care centers of which two were teaching hospitals. A comparison was made with data for the same period in 2019. For each patient, the following data were collected: date of surgery, age, sex, place of residence, and standardized descriptors used to classify the injury anatomically, context in which the injury occurred, and SARS-CoV-2 PCR status. Results: 1098 patients underwent surgery against 1266 over the same period in 2019, a non-significant difference of −13.3% (p = 0.11) [−39.2% in Week 13 (p = 0.02), +7.6% in Week 19 (p = 0.16)]. Except for bone injuries of the hand and wrist (+13.4%, p = 0.07), a decrease in activity was observed for all anatomic locations, and especially for the distal radius (−55.8%, p = 0.001), ankle (−40.5%, p = 0,01). The context in which the injury occurred changed, with in particular a significant decrease in the number of sport accidents (−80.0%, p < 0.001) and road traffic accidents (−41.8%, p = 0.04), and an increase in DIY and gardening accidents (+62.7%, p < 0.001). Conclusion: The decrease in emergency surgery was much less marked in this geographical area mildly affected by the pandemic. Health policy that sets ways to ensure continuity in the care needed by the population must be adapted locally when a global health crisis strikes. Level of proof: 4 – Descriptive epidemiological study.
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