Hip Fracture Outcomes During the COVID-19 Pandemic: Early Results From New York

LeBrun, Drake G.; Konnaris, Maxwell A.; Ghahramani, Gregory; Premkumar, Ajay; DeFrancesco, Chris J; Gruskay, Jordan A.; Dvorzhinskiy, Aleksey; Sandhu, Milan S; Goldwyn, Elan; Mendias, Christopher L.; Ricci, William M.

doi:10.1097/bot.0000000000001849

Cited by 105 publications

(186 citation statements)

References 24 publications

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“…The meta-analysis showed that the prevalence of comorbidity among surgical patients was with COVID-19 was 18% (95% CI: 10 to 25) which is in line with the results of included studies [28,30,36,56,98,99,103]. The subgroup analysis showed that dementia was the most prevalent comorbidity followed by hypertension and Diabetes Mellitus.…”

Section: Discussionsupporting

confidence: 81%

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Postoperative mortality among surgical patients with COVID-19: A systematic review and meta-analysis

Abate

Mantefardo

Basu

2020

Preprint

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Background: The coronavirus disease 2019 (COVID-19) pandemic puts perioperative providers and staff at risk of viral exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during aerosol-generating procedures, particularly in asymptomatic carriers. However, the perioperative risk for adverse outcomes in SARS-CoV-2 infected patients remain uncertain and the topic of debate. The current study was designed to determine the postoperative mortality in COVID-19 patients based on a systematic review and meta-analysis of the global published peer-reviewed literature.Methods: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019, to August15, 2020, without language restriction. All observational studies reporting the prevalence of mortality were included while case reports and reviews were excluded. The data from each study were extracted with two independent authors with a customized format excel sheet and the disagreements were resolved by the third author. The methodological quality of included studies was evaluated using a standardized critical appraisal Tool adapted from the Joanna Briggs Institute.Results: A total of 715 articles were identified from different databases and 45 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The meta-analysis revealed a very high global rate of postoperative mortality among COVID-19 patients of 20% (95% CI: 15 to 26) and a postoperative ICU admission rate of 15% (95% confidence interval (CI):10 to 21). Conclusion: The unexpected high postoperative mortality rate in SARS-CoV-2 infected patients of 20% in the global literature mandates further scrutiny in assuring appropriate surgical indications and perioperative surgical safety measures in this vulnerable cohort of patientsRegistration: This systematic review and meta-analysis was registered in Prospero's international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.

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Section: Discussionsupporting

confidence: 81%

“…Some studies showed that perioperative mortality of patients with COVID-19 was very high [30,32,46,[55][56][57] while some studies failed to identify signi cant mortality among patients with COVID-19 undergoing surgical procedures [28,54,58,59].…”

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confidence: 99%

Postoperative mortality among surgical patients with COVID-19: A systematic review and meta-analysis

Abate

Mantefardo

Basu

2020

Preprint

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“…The Meta-Analysis showed that the prevalence of comorbidity among surgical patients was with COVID-19 was 18% (95% CI: 10 to 25) which is in line with the results of included studies (21,23,29,49,90,91,95). The subgroup analysis showed that dementia was the most prevalent comorbidity followed by hypertension and Diabetes Mellitus.…”

Section: Discussionsupporting

confidence: 80%

“…Some studies showed that perioperative mortality of patients with COVID-19 was very high (23,25,39,(48)(49)(50) while some studies failed to identify signi cant mortality among patients with COVID-19 undergoing surgical procedures (21,47,51,52).…”

Section: Introductionmentioning

confidence: 99%

Global Prevalence of Perioperative Outcomes of Surgical Patients with COVID-19: A Systematic Review and Meta-Analysis

Abate¹,

Mantefardo²,

Basu³

2020

Preprint

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Background: Surgery during the COVID-19 pandemic is too challenging globally especially for low and middle-income countries in which the limping health care system is broken with low testing capacity, sub-optimal postoperative care, lack of anesthesia machine filters, and limited personal protective equipment. Body of evidence is lacking on the prevalence of perioperative outcomes of patients with COVID-19. Therefore, this study is aimed to provide the global prevalence of perioperative outcomes of patients with COVID-19.Methods: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 2019 to August 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All observational studies reporting the prevalence of mortality were included.Results: A total of 515 articles were identified from different databases and 50 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The Meta-Analysis revealed that the global prevalence of perioperative mortality among COVID-19 patients was 20% (95% CI: 15 to 26). The Meta-Analysis also revealed that the rate of postoperative ICU admission was 15% (95% confidence interval (CI):10 to 21).Conclusion: There is one death for every five COVID-19 patients undergoing surgical procedures which entails mitigating strategies to decrease perioperative mortality, provide less risky anesthetic techniques, and alternative management other than surgical procedures.Registration: This systematic review and meta-analysis was registered in Prospero's international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.

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“…However, the World Health Organisation has reported that of those who have tested positive worldwide, 6.9% have died [20]. In hospital, mortality rates have varied in the literature from 15 to 28.5% [13][14][15][16][21][22][23]. A recent UK study of 16,749 patients admitted to hospital with COVID-19 reports a mortality rate of 31% for patients with a wardbased level of care [10].…”

Section: Discussionmentioning

confidence: 99%

30-day mortality for fractured neck of femur patients with concurrent COVID-19 infection

Dupley

Oputa

Bourne

et al. 2020

Eur J Orthop Surg Traumatol

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Introduction Risk factors for mortality associated with COVID-19 have been reported to include increased age, male sex and certain comorbidities. Fracture neck of femur (NOF) patients is high-risk surgical patients, often with multiple comorbidities and advanced age. We quantify the 30-day mortality rate in fractured NOF patients with a positive peri-operative COVID-19 antigen test and identify risk factors for increased mortality. Methods This is a retrospective multi-centre review of all patients admitted with a fractured NOF and a confirmed laboratory diagnosis of COVID-19 between 1 March and 26 April 2020. Demographic data, comorbidities, ASA grade and date of death (if applicable) were collected. Results There were 64 patients in the cohort with an overall 30-day mortality rate of 32.8% (n = 21). Thirty-five (55%) were female, and mean age was 83 (SD 9, range 46-100) years. There was significantly increased mortality for those with a history of myocardial infarction (p = 0.03). Sixty-four percent of patients underwent surgery within the 36-h target, which is comparable to previous data for the same time of year. Overall mortality increased to 50% (n = 32) at 45 days post-operatively. Conclusion This is a large review of 30-day mortality in NOF patients with concurrent COVID-19 infection. We report a substantial increase from the pre-COVID-19 mean 30-day mortality rate (6.5% in 2019). We highlight the need for counselling patients when presenting with a NOF in relation to peri-operative COVID-19 infection and the associated increased risks. Keywords COVID-19 • SARS-CoV-2 • Fractured neck of femur • Mortality • Hip fracture All collaborators assisted with data collection, drafting of the paper and reviewing the final article. North West COVID NOF Study Group authors listed in Acknowledgements section.

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Hip Fracture Outcomes During the COVID-19 Pandemic: Early Results From New York

Abstract: Objective: To evaluate inpatient outcomes among patients with hip fracture treated during the COVID-19 pandemic in New York City.

Cited by 105 publications

References 24 publications

Postoperative mortality among surgical patients with COVID-19: A systematic review and meta-analysis

Postoperative mortality among surgical patients with COVID-19: A systematic review and meta-analysis

Global Prevalence of Perioperative Outcomes of Surgical Patients with COVID-19: A Systematic Review and Meta-Analysis

30-day mortality for fractured neck of femur patients with concurrent COVID-19 infection

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