Outpatient Wound Clinics During COVID-19 Maintained Quality but Served Fewer Patients.
Outpatient Wound Clinics During COVID-19 Maintained Quality but Served Fewer Patients.
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DOI：
10.1016/j.jamda.2021.11.001
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发表时间：
2022-04
影响因子：
7.6
通讯作者：
Ennis W
中科院分区：
文献类型：
--
作者：
Cho SK;Mattke S;Sheridan M;Ennis W
评估与covid -19相关的中断对慢性伤口护理连续性和结局的影响。回顾性队列研究。来自美国45个州和哥伦比亚特区488个伤口护理诊所网络的152225个慢性伤口的电子医疗记录。比较了2019年前两个季度和2020年前两个季度的伤口和患者特征、诊所新见的慢性伤口数量以及12周治愈率。构建多变量回归模型以评估大流行是否与风险调整后12周伤口愈合概率的统计学显著变化相关。在大流行期间，伤口和患者的特征与前一年相比没有变化。2020年4月，病例量下降了40%，但到6月又恢复到去年的水平。未观察到护理连续性措施的系统性变化。未经调整的12周愈合率在2019年和2020年分别稳定在0.502和0.503。同样，2019年和2020年经风险调整后的12周愈合率分别为0.504和0.505，但差异无统计学意义。封锁更严格的州的病例数量下降幅度更大。然而，在大多数州，大流行与12周伤口愈合概率的统计显著变化无关。1次或1次以上远程医疗就诊的伤口比例从2019年的0.14%上升到2020年的1.04%。尽管与covid -19相关的中断，我们的研究结果表明，伤口护理诊所保持了寻求治疗的患者的护理标准和结果。这一积极结果不应减损在诊所看到的新伤口数量急剧下降的问题。进一步的研究应该评估无护理慢性伤口患者的预后。
To evaluate the impact of COVID-19–related disruptions on care continuity and outcomes of chronic wounds. Retrospective cohort study. Electronic medical records for 152,225 chronic wounds from a network of 488 wound care clinics in 45 US states and the District of Columbia. Wound and patient characteristics, the number of chronic wounds newly seen at the clinics, and 12-week healing rates were compared between the first 2 quarters of 2019 and 2020. Multivariable regression models were constructed to evaluate whether the pandemic was associated with a statistically significant change in the probability of 12-week wound healing after risk adjustment. During the pandemic, wound and patient characteristics did not change compared to the previous year. Case volume dropped as much as 40% in April 2020 but returned to the previous year's level by June. No systematic changes in measures of care continuity were observed. Unadjusted 12-week healing rates remained stable at 0.502 in 2019 and 0.503 in 2020. Likewise, risk-adjusted 12-week healing rates were 0.504 and 0.505 in 2019 and 2020, respectively, but the difference was not statistically significant. States with stricter lockdowns saw a greater decline in case volume. However, the pandemic was not associated with a statistically significant change in the probability of 12-week wound healing in most states. The percentage of wounds with 1 or more telehealth visits increased from 0.14% in 2019 to 1.04% in 2020. Despite COVID-19–related disruptions, our results suggest that wound care clinics maintained standards of care and outcomes for patients who sought care. This positive result should not detract from the problem that the number of new wounds seen at the clinics dropped sharply. Further research should evaluate outcomes in patients with unattended chronic wounds.
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