SARS-CoV-2 Impact on Elective Orthopaedic Surgery Implications for Post-Pandemic Recovery
SARS-CoV-2 Impact on Elective Orthopaedic Surgery Implications for Post-Pandemic Recovery
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DOI：
10.2106/jbjs.20.00602
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发表时间：
2020-07-01
影响因子：
5.3
通讯作者：
Aggarwal, Shruti
中科院分区：
文献类型：
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作者：
Jain, Amit;Jain, Punya;Aggarwal, Shruti
背景资料：我们研究的目的是探讨择期手术延期对美国医疗体系的影响以及COVID-19控制后的后续恢复。使用骨科择期手术模型，我们的目的是回答以下问题：（1）什么是预期的恢复时间，直到医疗保健系统是恢复到几乎全部能力进行择期手术？(2)随着时间的推移，择期手术的预期积压是什么？(3)医疗保健应该如何改变以解决积压问题？研究方法：进行了基于蒙特卡罗随机模拟的分析，以预测大流行后择期住院全关节置换术和脊柱融合手术病例的数量。计算并分析了累积积压量。我们测试了模型假设与敏感性analysis.Results：假设择期骨科手术恢复在2020年6月，它将需要7个月，12个月，16个月-在乐观，矛盾和悲观的情况下，分别-直到医疗保健系统可以执行90%的预期大流行前预测的手术量。在乐观的情况下，将有一个累积的积压超过100万例手术后2年结束择期手术delegation.Conclusions：择期手术病例在SARS-冠状病毒-2大流行期间的延期将对美国的医疗保健系统产生持久的影响。作为减灾工作的一部分，现在就开始规划恢复工作至关重要。
Background: The aim of our study was to explore the impact of elective-surgery deferment on the United States healthcare system and subsequent recovery after COVID-19 containment. Using an orthopaedic elective surgery model, we aimed to answer the following: (1) What is the expected recovery time until the health-care system is back to nearly full capacity for performing elective surgery? (2) What will be the expected backlog of elective surgery over time? (3) How should health care change to address the backlog?Methods: A Monte Carlo stochastic simulation-based analysis was performed to forecast the post-pandemic volume of elective, inpatient total joint arthroplasty and spinal fusion surgical cases. The cumulative backlog was calculated and analyzed. We tested model assumptions with sensitivity analyses.Results: Assuming that elective orthopaedic surgery resumes in June 2020, it will take 7, 12, and 16 months-in optimistic, ambivalent, and pessimistic scenarios, respectively-until the health-care system can perform 90% of the expected pre-pandemic forecasted volume of surgery. In the optimistic scenario, there will be a cumulative backlog of >1 million surgical cases at 2 years after the end of elective-surgery deferment.Conclusions: The deferment of elective surgical cases during the SARS-CoV-2 pandemic will have a lasting impact on the United States health-care system. As part of disaster mitigation, it is critical to start planning for recovery now.