靖雅 黃

  • How does COVID-19 pandemic affect patients with pressure injury?

    Objective:
    Pressure injury (PI) is a common health issue among elderly people which needs long-term individual management. With COVID-19 spreading worldwide, it has significantly impacted healthcare systems and suspended medical treatments. This retrospective study aims to explore whether the COVID-19 pandemic altered conditions and surgery outcomes of patients with PI.

    Material and Methods:
    This study includes all pressure injury (PI) patients who underwent debridement or flap-reconstruction surgery during 2016–2019 (pre-COVID) and 2020–2021 (COVID) in Wan Fang hospital. We extracted patient demographics, surgical and blood test records, preoperative vital signs, and flap surgery outcomes for analysis.

    Results:
    In total, 464 surgeries were performed on 213 patients, including 308 pre-COVID and 156 COVID. During the COVID period, there were more patients presenting with dementia, and it had significantly more patients with >12,000 white blood cells/µL (24.03% vs. 15.59%, P = 0.029), higher C-reactive protein levels (7.13 ± 6.36 vs. 5.58 ± 5.09 mg/dL, P = 0.014), pulse rates (86.67 ± 14.76 vs. 81.26 ± 13.66 beats/min, P < 0.001), and respiratory rates (17.87 ± 1.98 vs. 17.31 ± 2.39 breaths/min, P = 0.009) but lower hemoglobin levels (9.75 ± 2.02 vs. 10.43 ± 1.67 mg/dL, P < 0.001) preoperatively. The number of flap surgeries has significantly decreased after the COVID pandemic period (28.57% vs. 16.03%, P = 0.002), but there is no significant difference of flap outcomes between groups. The results show that the pandemic of COVID-19 has significantly delayed the treatment and influenced the patient conditions. Insufficient hemoglobin, poor infection control, and unstable vital signs were noted in patients with PI during the COVID-19 pandemic.

    Conclusions:
    PI patient condition was generally worse during the COVID-19 pandemic because of reduced access to medical treatment. The uncorrected medical problems delayed the appropriate timing for patients with PI to undergo flap surgery. Thus, thorough early management and correction of patient conditions is urgent during the COVID-19 pandemic. This problem may be resolved through holistic care during a future pandemic or pandemic-like situation.

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