医院获得性COVID-19及其对骨科住院时间和死亡率的影响：一项匹配队列研究

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-03 DOI:10.1016/j.jor.2025.06.031

Itay Ron , Ammar Muati , David Shaked Zari , Bezalel Peskin , Nabil Ghrayeb , Doron Norman , Jacob Shapira

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引用次数: 0

摘要

医院获得性COVID-19对骨科患者构成了重大威胁，由于行动不便、合共病和住院时间延长，骨科患者已经处于危险之中。肌肉骨骼损伤和SARS-CoV-2感染的联合负担可能会延长恢复时间，增加并发症并影响生存。本研究旨在评估院内感染COVID-19对骨科患者住院结局的影响。方法对某三级骨科中心2020 - 2022年住院患者进行回顾性队列研究。入院时感染的covid -19阳性患者（n = 84）与未感染的对照组（n = 84）根据年龄、性别和BMI进行1:1匹配。收集了人口统计学、合并症、住院时间、并发症、ICU转移和死亡率结果的数据。统计分析包括t检验、Mann-Whitney U检验和p <的显著性集；0.05.结果scovid -19阳性患者的住院时间显著延长(中位13.9天vs. 4.3天，p <；0.001)，与对照组相比，出院后死亡时间更短（中位135天对540天，p = 0.027）。两组死亡率相似（23.8% vs 22.6%, p = 0.86），只有COVID-19组入院（3.3%）。基线特征和合并症具有可比性。结论骨科患者在住院期间感染COVID-19，尽管总体死亡率相似，但住院时间更长，死亡率更早。这些发现强调了感染预防策略的重要性，包括术前筛查和推迟感染者的选择性手术，以减轻与不活动、延迟恢复和全身衰退相关的并发症。

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Hospital-acquired COVID-19 and its effect on length of stay and mortality in orthopedic admissions: A matched cohort study

Introduction

Hospital-acquired COVID-19 poses a significant threat to orthopedic patients, a population already at risk due to immobility, comorbidities, and extended hospital stays. The combined burden of musculoskeletal injury and SARS-CoV-2 infection may prolong recovery, increase complications, and influence survival. This study aimed to evaluate the impact of nosocomial COVID-19 on hospitalization outcomes in orthopedic patients.

Methods

A retrospective cohort study was conducted at a tertiary orthopedic center, analyzing patients hospitalized between 2020 and 2022. COVID-19-positive patients (n = 84) who acquired the infection during admission were matched 1:1 with uninfected controls (n = 84) based on age, gender, and BMI. Data were collected on demographics, comorbidities, hospitalization duration, complications, ICU transfers, and mortality outcomes. Statistical analysis included t-tests, Mann-Whitney U tests, and significance set at p < 0.05.

Results

COVID-19-positive patients experienced significantly longer hospital stays (median 13.9 vs. 4.3 days, p < 0.001) and shorter time to death post-discharge (median 135 vs. 540 days, p = 0.027) compared to controls. Mortality rates were similar between groups (23.8 % vs. 22.6 %, p = 0.86), and ICU admissions occurred only in the COVID-19 group (3.3 %). Baseline characteristics and comorbidity profiles were comparable.

Conclusion

Orthopedic patients who contract COVID-19 during hospitalization face a prolonged hospital course and earlier mortality despite similar overall death rates. These findings highlight the importance of infection prevention strategies, including preoperative screening and deferring elective procedures in infected individuals, to mitigate complications associated with immobility, delayed recovery, and systemic decline.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.