Data Sheet 2_Epidemiology and factors associated with the perioperative course of patients undergoing hip fracture during the initial phase of the state of emergency declared in 2020.docx

IntroductionCurrently, there is no gold standard anesthetic plan for elderly patients with hip fractures who must undergo surgery. The state of alarm during 2020 due to the COVID-19 pandemic changed certain hospital paradigms, prompting an investigation into differences in anesthetic management and patient survival for hip fracture surgeries using gamma nail osteosynthesis in 2020 compared to 2019.
Materials and methodsA historical cohort study was conducted to assess morbidity and mortality, with data obtained from anonymized medical records.
ResultsStatistically significant differences were found, notably an increase in Body Mass Index during confinement. A statistically significant decrease in leukocyte and hemoglobin levels was observed after surgery. However, there were no statistically significant differences in mortality between 2019 and 2020. Patients who did not require vasoactive drugs during surgery to maintain blood pressure levels above 90/60 mmHg had a better survival rate.
ConclusionDespite the reduction in postoperative hospital surveillance time, no increase in complications was found. This allowed for early patient reintegration into daily life, early functional rehabilitation, and the minimization of economic costs.

引言
目前，对于需接受手术治疗的老年髋部骨折患者，尚无公认的金标准麻醉方案（gold standard anesthetic plan）。2020年新型冠状病毒肺炎（COVID-19）疫情期间的公共卫生警戒状态改变了部分医院的诊疗范式，由此推动了一项对比2019年与2020年采用伽马钉内固定术（gamma nail osteosynthesis）治疗髋部骨折时的麻醉管理方式与患者生存率差异的研究。

材料与方法
本研究为回顾性队列研究，旨在评估患者的发病率与死亡率，研究数据取自匿名化的病历资料。

结果
本研究发现存在统计学意义上的显著差异：疫情封控期间患者的体重指数（Body Mass Index, BMI）出现升高；术后患者的白细胞与血红蛋白水平出现具有统计学意义的下降。但2019年与2020年的患者死亡率未出现统计学显著差异。术中无需使用血管活性药物将血压维持在90/60mmHg以上的患者，其生存率更高。

结论
尽管术后住院监护时长有所缩短，但未出现并发症发生率升高的情况。这使得患者能够更早回归日常生活、开展早期功能康复，并最大限度降低医疗经济成本。