Open AccessFeatures of hospitalization of patients in the trauma and orthopedic center in the context of the second wave of the COVID-19 pandemic
Author(s) -
Н. С. Николаев,
N. V. Belova,
E. V. Preobrazhenskaya,
Yu. A. Malyuchenko,
N Yu Dobrovol'skaya,
E. A. Andronnikov
Publication year - 2021
Publication title -
nacionalʹnoe zdravoohranenie
Language(s) - English
Resource type - Journals
eISSN - 2713-0703
pISSN - 2713-069X
DOI - 10.47093/2713-069x.2021.2.1.63-72
Subject(s) - medicine , covid-19 , radiological weapon , asymptomatic , emergency medicine , pneumonia , orthopedic surgery , context (archaeology) , pandemic , traumatology , trauma center , pediatrics , retrospective cohort study , surgery , infectious disease (medical specialty) , disease , biology , paleontology
The algorithm for examining patients for SARS-CoV-2 during admission to non-infectious hospitals, a unified route scheme for patients taking into account the potential infectious hazard is not regulated. The aim of the study is to identify the features of the diagnosis of SARS-CoV-2 during planned hospitalization in the field of “traumatology and orthopedics”; to present schemes for examining patients for SARS-CoV-2 during hospitalization and patient routing in the clinic. Materials and methods . The route and procedure of examination to exclude the nosocomial spread of COVID-19 in patients hospitalized for three months is described. 3366 survey results were analyzed. Results. Positive PCR tests for COVID-19 before hospitalization were obtained in 4.5 % of patients. High titers of IgM are found in 7.8 % of cases. At the level of the Pass Office, 10.5 % of arrivals were denied hospitalization. The CT scan of the chest organs, which was then carried out, revealed among the examined 9.1 % of asymptomatic pneumonia, of which 93.5 % – with radiological signs of COVID-19, 2/3 of “covid” pneumonia – with a CT-0 degree. Another part of hospitalizations was postponed due to somatic contraindications during clinical examination. After all the selection stages, 73.2 % of planned hospitalizations ended up. In the hospital, 12 cases of COVID-19 were detected in the postoperative period, more often on the 4th day after the operation. A total of 2,328 patients were discharged during the study period – 69.2 % of planned hospitalizations, a third of patients received a medical withdrawal from hospitalization due to COVID-19. Conclusions. The peculiarities of admitting patients to planned hospitalization in the traumatology and orthopedics profile is the difficulty of reliably detecting COVID-19 in a limited time. In some cases of asymptomatic course, the disease is detected only with the help of CT diagnostics. In 0.5 % of cases, COVID-19 is detected in the postoperative period. The described patient routing scheme, multistage diagnostics to exclude COVID-19 are able to ensure maximum infectious safety of patients and staff in the clinic.