Evaluation of early complications, outcome, and mortality in Coronavirus Disease 2019 (COVID-19) infection in patients who underwent orthopedic surgery

Mohammadpour, Mehdi; Yazdi, Hamidreza; Bagherifard, Abolfazl; Moghtadaei, Mehdi; Torkaman, Ali; Yahyazadeh, Hooman; Ghaderi, Mohammad; Fanaeian, Mohammad Mahdi; Langeroudi, Moein Khaleghi; Hashemi, Peyman; Razi, Saeed; Karimpour, Amer; Lirgeshasi, Sam Bemani; Bahari, Milad

doi:10.1186/s12891-022-05010-8

Cited by 9 publications

(9 citation statements)

References 23 publications

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“…Studies that looked at elective and emergent orthopaedic surgical procedures in the presence of COVID-19 infection also found an increased risk of mortality and perioperative adverse events. 10–12 In a recent study by Deng et al 8 that compared risks of postoperative complications pre-COVID-19 to peri-COVID-19, early post-COVID-19, and late post-COVID-19 found that patients who were peri-COVID-19 had an increased risk of postoperative complications and patients who were early post-COVID-19 had an increased risk of pneumonia. Similar to previously published studies, this study found an increased risk of postoperative complications in patients undergoing elective surgery, although the risk varied by surgical subspecialty.…”

Section: Discussionmentioning

confidence: 99%

“…There are numerous studies of increased risk of postoperative complications in patients who undergo surgical procedures with a concomitant COVID-19 infection. 6,8,[10][11][12] In a study by Doglietto et al, 6 patients with COVID-19 infection undergoing general, vascular, thoracic, orthopaedic, and neurosur-gical procedures were at higher risk of 30-day mortality and pulmonary and thrombotic complications when compared with a matched cohort. Studies that looked at elective and emergent orthopaedic surgical procedures in the presence of COVID-19 infection also found an increased risk of mortality and perioperative adverse events.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative Outcomes in Patients Undergoing Orthopedic Surgery Within 90 Days of Coronavirus Disease 2019

Johnson

Stock

Petre

et al. 2022

J Am Acad Orthop Surg

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Introduction: Coronavirus disease 2019 has resulted in a global pandemic with several hundred million infections worldwide. COVID-19 causes systemic complications that last beyond the initial infection. It is not known whether patients who undergo elective orthopaedic surgeries after COVID-19 are at increased risk of complications. The purpose of this study was to evaluate whether patients who undergo orthopaedic procedures after recent COVID-19 diagnosis are at increased risk of complications compared with those who have not had a recent COVID-19 diagnosis. Methods: The TriNetX Research Network database was queried for patients undergoing elective orthopaedic surgeries from April 2020 to January 2022 in the following subspecialties: arthroscopic surgery, total joint arthroplasty, lumbar fusion, upper extremity surgery, foot and ankle (FA) surgery. Cohorts were defined by patients undergoing surgery with a diagnosis of COVID-19 from 7 to 90 days before surgery and those with no COVID-19 diagnosis 0 to 90 days before surgery. These cohorts were propensity-score matched based on differences in demographics and comorbidities. The matched cohorts were evaluated using measures of association analysis for complications, emergency department (ER) visits, and readmissions occurring 90 days postoperatively. Results: Patients undergoing arthroscopic surgery were more likely to experience venous thromboembolism (VTE) (P = 0.006), myocardial infarction (P = 0.001), and ER visits (P = 0.001). Patients undergoing total joint arthroplasty were more likely to experience VTE (P , 0.001), myocardial infarction (P , 0.001), pneumonia (P, 0.001), and ER visits (P = 0.037). Patients undergoing lumbar fusion were more likely to experience VTE (P = 0.016), infection (P , 0.001), pneumonia (P , 0.001), and readmission (P = 0.006). Patients undergoing upper extremity surgery were more likely to experience VTE (P = 0.001) and

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postoperative Outcomes in Patients Undergoing Orthopedic Surgery Within 90 Days of Coronavirus Disease 2019

Johnson

Stock

Petre

et al. 2022

J Am Acad Orthop Surg

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“…This also accords with other earlier studies from Italy 54 and Iran. 55 This can be due to challenges in the identification and management of surgical site infection in COVID-19 patients, and…”

Section: Dovepressmentioning

confidence: 99%

COVID-19 Case Fatality Rate and Factors Contributing to Mortality in Ethiopia: A Systematic Review of Current Evidence

Girma¹,

Dejene²,

Geleta³

et al. 2022

IDR

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Background:The ongoing novel coronavirus disease 2019 (COVID-19) is triggering significant morbidity and mortality due to its contagious nature and absence of definitive management. In Ethiopia, despite a number of primary studies have been conducted to estimate the case fatality rate (CFR) of COVID-19, no review study has attempted to summarize the findings to better understand the nature of pandemics and the virulence of the disease. Objective: To summarize the CFR of COVID-19 and factors contributing to mortality in Ethiopia. Methods: PRISMA guideline was followed. PubMed, Science Direct, CINAHL, SCOPUS, Hinari, and Google Scholar were systematically searched using pre-specified keywords. Observational studies ie, cohort, cross-sectional, and case-control studies were included. The Newcastle-Ottawa scale adapted for observational studies was used to assess the quality of included studies. CFR was defined as the proportion of COVID-19 cases with the outcome of death within a given period. Factors contributing to COVID-19 mortality at p-value <0.05 were described narratively from the eligible articles. Results: A total of 13 observational studies were included in this study. Consequently, this review confirmed the CFR of COVID-19 in Ethiopia ranges between 1-20%. Additionally, comorbid conditions, older age group, male sex, substance use, clinical manifestations (abnormal oxygen saturation level, atypical lymphocyte count, fever, and shortness of breath), disease severity, and history of surgery/trauma increased the likelihood of death from COVID-19 death. Conclusion:This study shows that the range of CFR of COVID-19 in Ethiopia is almost equivalent to other countries, despite the country's low testing capacity and case detection rate in reference to its total population. Comorbid diseases, older age group, male sex, cigarette smoking, alcohol drinking, clinical manifestations and disease severity, and history of surgery/trauma were factors contributing to COVID-19 mortality in Ethiopia. Therefore, given the alarming global situation and rapidly evolving large-scale pandemics, urgent interdisciplinary interventions should be implemented in those vulnerable groups to lessen the risk of mortality. Furthermore, the CFR of COVID-19 should be estimated from all treatment and rehabilitation centers in the country, as underestimation could be linked to a lack of preparedness and mitigation. A large set of prospective studies are also compulsory to better understand the CFR of COVID-19 in Ethiopia.

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“…In addition, our study is much larger than the study by Zhong et al and has greater power because of this larger sample size. Mohammadpour et al 14 conducted a prospective cohort study of 6,571 patients undergoing elective and emergent orthopaedic procedures between February 2020 and September 2020. They found a 9.3% mortality rate for patients undergoing these procedures.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on Elective Orthopaedic Surgery Outcomes During the Peak of the Pandemic, an Uptick of Complications: An Analysis of the ACS-NSQIP

et al. 2023

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Introduction: Since the World Health Organization declared a pandemic in March 2020, COVID-19 has pressured the healthcare system. Elective orthopaedic procedures for American seniors were canceled, delayed, or altered because of lockdown restrictions and public health mandates. We sought to identify differences in the complication rates for elective orthopaedic surgeries before and atfter the pandemic onset. We hypothesized that complications increased in the elderly during the pandemic. Methods: We conducted a retrospective analysis of the American College of Surgeons–National Surgical Quality Improvement Program database in patients older than 65 years undergoing elective orthopaedic procedures from 2019 (prepandemic) and April to December 2020 (during the pandemic). We recorded readmission rates, revision surgery, and 30-day postoperative complications. In addition, we compared the two groups and adjusted for baseline features with standard multivariate regression. Results: We included 146,430 elective orthopaedic procedures in patients older than 65 years (94,289 before the pandemic and 52,141 during). Patients during the pandemic had a 5.787 times greater chance of having delayed wait time to the operating room ( P < 0.001), a 1.204 times greater likelihood of readmission ( P < 0.001), and a 1.761 times increased chance of delayed hospital stay longer than 5 days ( P < 0.001) when compared with prepandemic. In addition, during the pandemic, patients were 1.454 times more likely to experience any complication ( P < 0.001) when compared with patients prepandemic undergoing orthopaedic procedures. Similarly, patients were also 1.439 times more likely to have wound complication ( P < 0.001), 1.759 times more likely to have any pulmonary complication ( P < 0.001), 1.511 times more likely to have any cardiac complication ( P < 0.001), and 1.949 times more likely to have any renal complication ( P < 0.001). Conclusion: During the COVID-19 pandemic, elderly patients faced longer wait times within the hospital and increased odds of complications after elective orthopaedic procedures than similar patients before the pandemic.

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Evaluation of early complications, outcome, and mortality in Coronavirus Disease 2019 (COVID-19) infection in patients who underwent orthopedic surgery

Cited by 9 publications

References 23 publications

Postoperative Outcomes in Patients Undergoing Orthopedic Surgery Within 90 Days of Coronavirus Disease 2019

Postoperative Outcomes in Patients Undergoing Orthopedic Surgery Within 90 Days of Coronavirus Disease 2019

COVID-19 Case Fatality Rate and Factors Contributing to Mortality in Ethiopia: A Systematic Review of Current Evidence

Impact of COVID-19 on Elective Orthopaedic Surgery Outcomes During the Peak of the Pandemic, an Uptick of Complications: An Analysis of the ACS-NSQIP

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