History of COVID-19 Was Not Associated With Length of Stay or In-Hospital Complications After Elective Lower Extremity Joint Replacement

Jungwirth-Weinberger, Anna; Boettner, Friedrich; Kapadia, Milan; Diane, Alioune; Chiu, Yu-Fen; Lyman, Stephen; Fontana, Mark Alan; Miller, Andy O.

doi:10.1016/j.artd.2021.11.021

Cited by 6 publications

(8 citation statements)

References 29 publications

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“…One multicenter cohort study of hip fracture patients in the UK found that SARS-CoV-2 positive patients had an increased length of postoperative hospital stay compared to controls (13.8 days vs. 6.7 days, P < 0.001) ( 21 ). These results are somewhat discordant with those of Jungwirth-Weinberger et al ( 22 ), who reported that SARS-CoV-2 was not predictive of post-arthroplasty median length of stay after controlling for confounding variables such as age, sex, and comorbidity index ( 22 ). In a cardiac surgery patient cohort, the average length of postoperative stay for SARS-CoV-2 positive patients was 3 days, compared to 1.8 days in controls ( P = 0.002) ( 23 ).…”

Section: Discussionsupporting

confidence: 76%

Positive SARS-CoV-2 detection on intraoperative nasopharyngeal viral testing is not associated with worse outcomes for asymptomatic elective surgical patients

2022

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BackgroundIt has been demonstrated that surgical patients with COVID-19 are at increased risk for postoperative complications. However, this association has not been tested in asymptomatic elective surgical patients.MethodsA retrospective cohort study among elective gynecological and spine surgery patients at a single tertiary medical center from July 2020 through April 2022 (n = 1,130) was performed. The primary endpoint was prolonged (>75th percentile for the corresponding surgical service) length of stay. Secondary endpoints included postoperative respiratory complications, duration of supplemental oxygen therapy, and other major adverse events. The association between SARS-CoV-2 detection and the above outcomes was investigated with univariate and multivariable analyses.FindingsOf 1,130 patients who met inclusion criteria, 30 (2.7%) experienced intraoperative detection of SARS-CoV-2. Those with intraoperative viral detection did not experience an increased incidence of prolonged length of stay [16.7% vs. 23.2%; RR, 0.72 (95% CI, 0.32–1.61); P = 0.531] nor did they have a longer mean length of stay (4.1 vs. 3.9 days; P = 0.441). Rates of respiratory complications [3.3% vs. 2.9%; RR, 1.15 (95% CI, 0.16–8.11); P = 0.594] and mean duration of supplemental oxygen therapy (9.7 vs. 9.3 h; P = 0.552) were similar as well. All other outcomes were similar in those with and without intraoperative detection of SARS-CoV-2 (all P > 0.05).InterpretationAsymptomatic patients with incidental detection of SARS-CoV-2 on intraoperative testing do not experience disproportionately worse outcomes in the elective spine and gynecologic surgical population.

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Section: Discussionsupporting

confidence: 76%

Positive SARS-CoV-2 detection on intraoperative nasopharyngeal viral testing is not associated with worse outcomes for asymptomatic elective surgical patients

2022

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“…Statistical analyses were performed using SAS 9.4 (SAS Institute Inc., Cary, NC, USA). Using a significance level of 0.05 and a power of 90%, power analysis revealed a 3-hour difference ( 10 ) in hospital LOS would be detected with 462 patients in each cohort. To account for a potentially high dropout rate in the midst of the pandemic, we aimed to increase our patient cohort by over 50%.…”

Section: Methodsmentioning

confidence: 99%

Reduction in hospital length of stay and increased utilization of telemedicine during the “return-to-normal” period of the COVID-19 pandemic does not adversely influence early clinical outcomes in patients undergoing total hip replacement: a case-control study

Sarpong

Kuyl

Ong

et al. 2022

ActaO

Self Cite

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Background and purpose: Elective total hip replacement (THR) was halted in our institution during the COVID-19 surge in March 2020. Afterwards, elective THR volume increased with emphasis on fast-track protocols, early discharge, and post-discharge virtual care. We compare early outcomes during this “return-to-normal period” with those of a matched pre-pandemic cohort.Patients and methods: We identified 757 patients undergoing THR from June to August 2020, who were matched 1:1 with a control cohort from June to August 2019. Length of stay (LOS) for the study cohort was lower than the control cohort (31 vs. 45 hours; p < 0.001). The time to first postoperative physical therapy (PT) was shorter in the study cohort (370 vs. 425 minutes; p < 0.001). More patients were discharged home in the study cohort (99% vs. 94%; p < 0.001). Study patients utilized telehealth office and rehabilitation services 14 times more frequently (39% vs. 2.8%; p < 0.001). Outcomes included post-discharge 90-day unscheduled office visits, emergency room (ER) visits, complications, readmissions, and PROMs (HOOS JR, and VR-12 mental/physical). Mann–Whitney U and chi-square tests were used for group comparisons.Results: Rates of 90-day unscheduled outpatient visits (5.0% vs. 7.3%), ER visits (5.0% vs. 4.8%), hospital readmissions (4.0% vs. 2.8%), complications (0.04% vs. 0.03%), and 3-month PROMs were similar between cohorts. There was no 90-day mortality.Interpretation: A reduction in LOS and increased telehealth use for office and rehabilitation visits did not adversely influence 90-day clinical outcomes and PROMs. Our findings lend further support for the utilization of fast-track arthroplasty with augmentation of postoperative care delivery using telemedicine.

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“…Although the population of patients with a previous history of COVID-19 is insufficient to draw definitive conclusions, based on these results, we can say that patients who fully recover from COVID-19 may be good candidates for joint surgery. Similarly to us, a study by Jungwirth-Weinberger et al on the impact of previous COVID-19 infection on the complications of elective arthroplasty reported that previous COVID-19 infection did not lead to an extended hospital stay or more complications at the hospital ( 62 ). Furthermore, the same authors found that patients with a positive history of COVID-19 had a low rate of VTE following arthroplasty ( 63 ).…”

Section: Discussionmentioning

confidence: 65%

COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19-vaccinated Patients: A Multicenter Comparative Cohort Study

Salimi¹,

Moharrami²,

Dolama³

et al. 2022

Arthroplasty Today

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History of COVID-19 Was Not Associated With Length of Stay or In-Hospital Complications After Elective Lower Extremity Joint Replacement

Cited by 6 publications

References 29 publications

Positive SARS-CoV-2 detection on intraoperative nasopharyngeal viral testing is not associated with worse outcomes for asymptomatic elective surgical patients

Positive SARS-CoV-2 detection on intraoperative nasopharyngeal viral testing is not associated with worse outcomes for asymptomatic elective surgical patients

Reduction in hospital length of stay and increased utilization of telemedicine during the “return-to-normal” period of the COVID-19 pandemic does not adversely influence early clinical outcomes in patients undergoing total hip replacement: a case-control study

COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19-vaccinated Patients: A Multicenter Comparative Cohort Study

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