新型冠状病毒肺炎疫情期间老年患者骨折流行病学特点分析

Epidemiological characteristic analysis of fractures in elderly patients during the breakout of Corona Virus Disease 2019(COVID-19)

目的分析新冠肺炎疫情期间老年患者骨折的临床特点。方法回顾性收集河北医科大学第三医院老年骨科2020年1月20日至2月19日收治的老年骨折患者(65岁以上)作为观察组,以2019年1月31日至3月2日(农历与2020年相对应)收治的老年骨折患者作为对照组,比较两组同一时间区域内收治患者的性别、年龄、骨折类型、合并疾病、致伤因素、治疗方式、术前等待时间、住院天数及围术期并发症的差异。结果本研究共收集患者134例,观察组53例,男性19例,女性34例,男女构成比1∶1.79,平均年龄(81±8)岁;对照组81例,男性23例,女性58例,男女构成比1∶2.52,平均年龄(79±8)岁。观察组合并陈旧脑梗塞患者(30例,56.60%)高于对照组(29例,35.80%,c2=5.625,P<0.05),跌倒患者(53例,100%)占比高于对照组(71例,87.65%,c2=5.396,P<0.05)。致伤原因中,站立不稳(18例,33.96%)占比高于对照组(8例,11.27%,c2=9.432,P<0.05),浴室滑倒(15例,28.30%)占比高于对照组(6例,8.45%,c2=8.501,P<0.05)。围术期方面,术前等待时间[5(4,7.25)d]长于对照组[4(3,5)d,P<0.05],住院天数[12(9,15)d]长于对照组[10(6,13)d,P<0.05];并发肺部感染几率(36例,67.92%)高于对照组(16例,19.75%,c2=31.306,P<0.05),下肢深静脉血栓几率(31例,58.49%)高于对照组(24例,29.63%,c2=11.028,P<0.05)。结论本研究提示疫情期间我院收治的新发骨折患者较去年同期显著减少。合并脑血管病的老年人是预防骨折的重点人群,致伤原因以居家跌倒为主。由于术前等待时间和住院时间延长,住院患者应重点预防围术期肺部感染及下肢深静脉血栓等并发症。

Objectives To analyze the clinical characteristics of fracture in elderly patients during the outbreak of Corona Virus Disease 2019(COVID-19).Methods Retrospective collection of data was performed on elderly patients(65 years and older)with fractures in the Third Hospital of Hebei Medical University between January 20 and February 192020,who were defined as case group.While,patients admitted between 2019 January 31 and March 2(corresponding to the lunar calendar and 2020)were allocated as control group,with comparison to the case group in term of gender,age,fracture type,merge disease,injury factors,treatment,preoperative waiting time,hospitalization days and the perioperative complications.Results A total of 134 elderly patients with fractures were collected in this study,including 53 in the case group,with 19males and 34 females(M∶F=1∶1.79)and an average age of 81±8 years,and 81 cases in the control group,with 23 males and 58 females(M∶F=1∶2.52)and an average age of 79±8 years.The proportion of patients with history of cerebral infarction in the case group(30 cases,56.60%)was higher than that in the control group(29 cases,35.80%,c2=5.625,P<0.05),and the proportion of patients falling down(53 cases,100%)is higher than that of the control group(71 cases,87.65%,c2=5.396,P<0.05).The proportion of patients with fractures caused by standing instability in the case group(18 cases,33.96%)was higher than that in the control group(8 cases,11.27%,c2=9.432,P<0.05),and the proportion of patients with fractures caused by bathroom slipping(15 cases,28.30%)was higher than that of the control group(6 cases,8.45%,c2=8.501,P<0.05).During perioperative period,the preoperative waiting time in the observation group[5(4,7.25)d]was longer than that in the control group[4(3,5)d,P<0.05],and the length of hospital stay[12(9,15)d]was longer than that of the control group[10(6,13)d,P<0.05];The incidence of pulmonary infection in the case group(36 cases,67.92%)was higher than that in the control group(16 cases,19.75%,c2=31.306,P<0.05),and the incidence of deep vein thrombosis(31 cases,58.49%)was higher than that of the control group(24 cases,29.63%,c2=11.028,P<0.05).Conclusions This study suggests that the number of new fracture patients admitted to our hospital during the epidemic period is significantly lower than the same period last year.The elderly with cerebrovascular disease is the primary population for prevention of fracture,and home was the most predominant place.Due to the prolonged preoperative waiting time and hospital stay,the inpatients should focus on the prevention of perioperative pulmonary infection,deep venous thrombosis and other complications.