ABSTRACT
COVID-19 has spread all over the world since December 2019. Although normal work and production have resumed after the epidemic has been preliminarily controlled in China, the situation of prevention and control of the re-spread of COVID-19 in China is still severe and medical institutions are still facing a great pressure in a certain period of future because part of the patients may become re-positive after healing and input cases from abroad are increasing.Based on the 2016 edition of Technical Operating Norms for Cleaning and Disinfection and Sterilization in Hospital Central Sterile Supply Department, the 2012 edition of Technical Standards for Disinfection in Medical Institutions, Prevention and Control Protocols of 2019-nCoV(5 th edition) and Diagnosis and Treatment Protocols of 2019-nCoV (6th trial version), The Central Sterile Supply Department at The Third Hospital of Hebei Medical University has worked out Recycling Procedures for Medical Instruments After 2019-nCoV Infection, Collection Procedures for Medical Instruments After 2019-nCoV Infection, and Vehicle Transport Procedures for Medical Instruments After 2019-nCoV Infection.These contingency plans may be useful references for other Central Sterile Supply Department(CSSD) during the COVID-19 epidemic.
ABSTRACT
Objective:To compare clinical characteristics of orthopedic trauma patients between the patients during pandemic of corona virus disease 2019 (COVID-19) and those beyond the pandemic period and analyze the factors influencing fracture site changes during pandemic of COVID-19.Methods:A retrospective case-control study was made on data of 1 048 patients with fractures hospitalized in Third Hospital of Hebei Medical University treated from January 20, 2020 to February 25, 2020 (pandemic period group) and from January 31, 2019 to March 9, 2019 (beyond pandemic period group). There were 232 patients in pandemic period group, including 121 males (52.2%) and 111 females (47.8%), with age range of 1-100 years [(47.9±26.3)years]. There were 816 patients in beyond pandemic period group, including 454 males (55.6%) and 363 females (44.5%), with age range of 1-96 years [(47.3±23.9)years]. Fracture sites were compared between the two groups. Age, sex, occupation, cause of injury, history of basic medical diseases, location of fracture, residence, marital status and other factors among the patients with low limb fractures and other fractures in pandemic period group were analyzed using the Logistic regression analysis.Results:Incidence of limb fractures in pandemic period group (69.4%, 161/232) was significantly higher than that in beyond pandemic period group (59.8%, 488/816) ( P<0.05), while the incidence of whole-body multiple fractures in pandemic period group (8.2%, 19/232) was significantly lower than that in beyond pandemic period group (13.6%, 111/816) ( P<0.05). Univariate analysis showed that female, middle or older age, farmers, low-energy injury, basic medical disease, staying at home were risk factors for limb fracture during pandemic ( P<0.05). Multivariate Logistic regression analysis showed low-energy injury ( OR=8.264, P<0.01) was an independent risk factor for limb fracture during pandemic. Conclusions:Compared with the beyond pandemic period, some location of fracture is changed and incidence of limb fracture is increased during pandemic. Low energy injury is an independent risk factor of limb fracture during the pandemic.
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Objective To analyze the epidemiological characteristics of all the patients with tibial plateau fracture admitted to the Third Hospital of Hebei Medical University in the past 10 years.Methods The picture achieving and communication system was used to collect the general information and disease-related information from the hospitalized patients with tibial plateau fracture who met the inclusion and exclusion criteria from January 1,2009 to December 31,2018.The patients from January 1,2009 to December 31,2013 were assigned into group A while those from January 1,2014 to December 31,2018 into group B.The 2 groups were compared to find out the epidemiological characteristics and trends of tibial plateau fractures in the past 10 years in gender,age,occupation,injury cause and Schatzker classification.Results A total of 1,936 patients with tibial plateau fracture were included in the study,including 1,352 males and 584 femaleswith a male to female ratio of 2.32∶ 1.The peak age ranged from 50 to 59 years,with 40 to 49 years for males and 50 to 59 for females.There were 793 cases in group A (a male to female ratio of 1.89∶1) and 1,143 ones in group B (2.69∶1),showing a significant difference between the 2 groups in the male to female ratio (P ＜ 0.05).The peak age ranged from 40 to 49 years (25.09％,199/793) in group A and from 50 to 59 years (23.27％,266/1,143)in group B.There were significant differences between the 2 groups in the constituent ratios of age groups from ≥50 years (P ＜ 0.05).Physical workers accounted for the highest proportion in group A (57.12％,453/793) and group B (52.58％,601/1,143).There were significant differences between the 2 groups in the constituent ratios of occupations (P ＜ 0.05).In all the 1,837 patients with a definite injury cause,the fall and indoor activity accounted for the highest proportion(41.92％,770/1,837),the traffic accident(33.25％,248/769) in group A did and the fall and indoor activity(48.88％,522/1,068) in group B did too.There were significant differences between the 2 groups in the injury causes (P ＜ 0.05).Of all the 1,658 patients with X-ray films available,by the Schatzker classification,types Ⅱ and Ⅵ were the most common.Type Ⅵ accounted for the highest proportion in group A (33.25％,248/769) while type Ⅱ did in group B (48.88％,522/1,068).There were significant differences between the 2 groups in the proportions of Schatzker types (P ＜ 0.05).Conclusions The tibial plateau fractures admitted to the Third Hospital of Hebei Medical University in the past 10 years were more common in males than in females,and predominant in physical workers.Fall and indoor activity was the most common injury cause.Schatzker types Ⅱ and Ⅵ prevailed.The fractures showed an aging trend by comparing the former 5 years and the latter 5 years.
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Objective To investigate the epidemiological characteristics of the in-patients with femoral supracondylar fracture in the Third Hospital of Hebei Medical University from 2009 through 2018.Methods The medical imaging computer archiving and transmission system and the medical record inquiry system were used to collect the data of all the in-patients with femoral supracondylar fracture who had been treated from January 2009 through December 2018 in The Third Hospital of Hebei Medical University.Their gender and age distribution,basic sociological data and cause of injury were characterized.The in-patients from January 2009 to December 2013 were assigned into group A while those from January 2004 to December 2018 into group B.The 2 groups were compared to find out the epidemiological characteristics and trends of the in-patients with femoral supracondylar fracture in the 10 years.Results Of the 508 in-patients with femoral supracondylar fracture,279 (54.9％) were male and 229 (45.1％) female.Their age ranged from 1 to 94 years,averaging 44.3 years.The age group from 41 to 50 years accounted for the largest proportion (104 cases,23.9％).In males,the age group from 41 to 50 years accounted for the largest proportion (33.3％,80/279);in females,the age group from 51 to 60 years the largest proportion (30.3 ％,59/229).The proportion of females in the in-patients under 50 years of age (37.1％) was significantly lower than that (62.9％) in the in-patients over 50 years of age (P ＜ 0.05).According to the AO classification,there were 193 cases (38％) of type 33-A1,117 ones (23％) of type 33-A2 and 198 ones (39％) of type 33-A3.There were 270 farmers (53.1％),164 workers (32.4％) and 74 students (14.5％).Most injuries were caused by high energy (56.5％).The age of in-patients with low-energy injury (50.5 ±20.7 years) was significantly higher than that of in-patients with high-energy injury (39.5 ± 19.6 years) (P ＜0.05).The proportions of urban residents (30.0％),patients with low energy injury (37.9％) and type 33-A1 fractures (23.9％) in group A were significantly lower than in group B (43.3％,46.9％ and 32.3％,respectively) (P ＜ 0.05);the age of group A (41.9 ± 21.8 years) was significantly younger than that of group B (45.9 ± 19.9 years) (P ＜0.05);type 33-A3 fractures in group A (46.5％) were significantly more than in group B (36.3％) (P ＜0.05).Conclusions Femoral supracondylar fractures were more common in farmers.Most of the fractures were type 33-A3.The fractures were common in males from 41 to 50 years old and in females from 51 to 60 years old.There were more males than females in the junior patients but more females than males in senior patients.There were more young patients in complex fractures but there were more old patients in simple fractures and there were more very old patients in low-energy injuries.In the past 10 years,the patients with femoral supracondylar fracture increased year by year.Compared with the first 5 years,the late 5 years witnessed significant increases in age of patients and proportions of low-energy injury and simple fracture.