Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective

Egol, Kenneth A.; Konda, Sanjit R.; Bird, Mackenzie L.; Dedhia, Nicket; Landes, Emma K; Ranson, Rachel; Solasz, Sara; Aggarwal, Vinay K.; Bosco, Joseph; Furgiuele, David; Ganta, Abhishek; Gould, Jason; Lyon, Thomas; McLaurin, Toni M; Tejwani, Nirmal C.; Zuckerman, Joseph D.; Leucht, Philipp

doi:10.1097/bot.0000000000001845

Cited by 179 publications

(351 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%

“…Many complications were mentioned in the literature in patients with COVID-19 who underwent surgical procedures [28,36,45,46,59,[97][98][99]104]. The meta-analysis revealed that thromboembolic disease, pulmonary complications, infection, and deep wound infection were the commonest perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

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

Abate

Mantefardo

Basu

2020

Preprint

View full text Add to dashboard Cite

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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%

“…The Meta-Analysis showed that the pooled mean duration of hospitalization was 10.55 (95% con dence interval (CI): 8.08 to 13.03) which is comparable with the ndings of the included studies (21,29,38,39,52,(89)(90)(91)96).…”

Section: Discussionsupporting

confidence: 67%

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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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Mortality among hip fracture patients infected with COVID-19 perioperatively

Fessler

Jacobsen

Lauritzen

et al. 2021

Eur J Trauma Emerg Surg

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Background and purpose The outbreak of the COVID-19 pandemic has resulted in an overall decline in fractures. However, the amount of hip fractures has remained relatively stable throughout the period. The objective of this study is to investigate the impact of perioperative COVID-19 infections on mortality among hip fracture patients. Methods A meta-analysis was performed by collecting current data available through a systematic literature search in the PubMed database. The search was performed Oct 18 2020. Results The meta-analysis was conducted on a trial population consisting of 1.272 hip fracture patients with a pooled prevalence of COVID-19 of 18%. Mortality among hip fracture patients without a perioperative COVID-19 infection was 7.49%. Mortality among hip fracture patients infected with COVID-19 perioperatively was associated with an odds ratio of 6.70 [(95% CI 4.64–9.68), p < 0.00001, I 2 = 41%]. A sensitivity analysis showed no major impact of assumptions regarding varying definitions of COVID-19 statuses among the included studies. Conclusion Perioperative infections with COVID-19 in hip fracture patients are correlated with a significantly increased mortality. The meta-analysis showed a pooled odds ratio of 6.70 [(95% CI 4.64–9.68), p < 0.00001, I 2 = 41%].

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Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective

Abstract: To examine one health system's response to the essential care of its hip fracture population during the COVID-19 pandemic and report on its effect on patient outcomes.

Cited by 179 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

Mortality among hip fracture patients infected with COVID-19 perioperatively

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