Management of orthopedic oncology patients during coronavirus pandemic

Şahbat, Yavuz; Buyuktopcu, Omer; Topkar, Osman Mert; Erol, Bülent

doi:10.1002/jso.26092

Cited by 9 publications

(14 citation statements)

References 13 publications

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“…However, as the duration of the pandemic is longer than expected, the treatment of patients other than fracture remains a concern in the orthopedic practice. Some authors [33][34][35] have suggested that new treatment guidelines should be created during the pandemic period for different subspecialties, such as pediatric orthopedics, orthopedic oncology, and shoulder and elbow surgery.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study

et al. 2021

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Objectives: The aim of this study was to evaluate the impact of novel coronavirus-2019 (COVID-19) on the epidemiological characteristics of orthopedic fractures. Patients and methods: A total of 2,960 patients (1,755 males, 1,205 females; mean age: 39.6 years; range, 1 to 98 years) with orthopedic fractures were included in the study: 552 patients during the pandemic period (March 10th and July 1st, 2020) and 1,158 control patients in the same period 2019 and 1,250 control patients in 2018. Epidemiological characteristics, injury mechanisms, fracture locations and treatment details of the patients were analyzed and compared between 2018, 2019 and 2020 for adult and pediatric populations. Results: Of a total of 552 patients, 485 were adults and 67 were pediatric patients. In the control groups, of 1,158 patients (2019), 770 were adults and 378 were pediatric patients and, of 1,250 patients (2018), 857 were adults and 393 were pediatric patients. The proportion of proximal femur and hand fractures significantly increased during the pandemic period (p=0.025 and p=0.038, respectively). The most frequent surgical indication in the pandemic period was proximal femoral fracture. The proportion of home accidents as an injury mechanism significantly increased in the pandemic period compared to 2018 and 2019 (48.5% vs. 18.6% and 20.6%, respectively; p=0.000). The proportion of female pediatric patients significantly increased during the pandemic period compared to 2018 and 2019 (44.8% vs. 25.4% and 27.2%, respectively, p=0.004). The proportion of forearm fractures (p=0.001) also increased, and the proportion of tibia-fibula fractures (p=0.03) decreased. The most frequent surgical indication in pediatric patients was distal humeral fracture in both groups. Conclusion: During the pandemic period, proximal femoral fractures in the elderly remained a concern. In-home preventative strategies may be beneficial to reduce the incidence of hip fractures in the elderly.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study

et al. 2021

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“…Preserving orthopaedic services during the COVID‐19 pandemic has been challenging internationally 3,4 . Trauma, spinal emergencies and urgent orthopaedic oncology have continued during the pandemic, and recent landmark studies have reported 30‐day mortality rates of 28.8% in orthopaedic patients 1 .…”

Section: Discussionmentioning

confidence: 99%

Mortality of high‐risk orthopaedic oncology patients during the COVID‐19 pandemic: A prospective cohort study

Stevenson

Evans

Morris

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: Should the threshold for orthopaedic oncology surgery during the coronavirus disease-2019 (COVID-19) pandemic be higher, particularly in men aged 70 years and older? This study reports the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during, respiratory complications and 30-day mortality during the COVID-19 pandemic. Methods: This prospective observational cohort study included 100 consecutive patients. The primary outcome measure was 14-day symptoms and/or SARS-CoV-2 test. The secondary outcome was 30-day postoperative mortality. Results: A total of 100 patients comprising 35 females and 65 males, with a mean age of 52.4 years (range, 16-94 years) included 16 males aged greater than 70 years. The 51% of patients were tested during their admission for SARS-CoV-2; 5% were diagnosed/developed symptoms of SARS-CoV-2 during and until 14 days postdischarge; four were male and one female, mean age 41.2 years (range, 17-75 years), all had primary malignant bone or soft-tissue tumours, four of five had received immunosuppressive therapy pre-operatively. The 30-day mortality was 1% overall and 20% in those with SARS-CoV-2. The pulmonary complication rate was 3% overall. Conclusions: With appropriate peri-operative measures to prevent viral transmission, major surgery for urgent orthopaedic oncology patients can continue during the COVID-19 pandemic. These results need validating with national data to confirm these conclusions.

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“…При метастатическом поражении позвоночника хирургическое лечение зачастую проводится по жизненным показаниям, так как нарастающая компрессия спинного мозга становится причиной развития плегии. Наличие у пациента патологического перелома длинных костей также является показанием к проведению экстренного хирургического лечения [3,4]. В исследовании J. Stevenson и соавт.…”

Section: Discussionunclassified

Experience of the department of surgical treatment of bone and soft tissue tumors during COVID-19 pandemic period

et al. 2021

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Since December 2019 the new coronavirus disease (COVID-19) has hit the world, causing the World Health Organization to declare it a pandemic. With the emergence and spread of the new infection, there has been unprecedented pressure on health care systems around the world. The time constraints associated with receiving routine care also affected the risk group cancer patients, as some hospitals were quarantined. Violation of the terms of both systemic drug, radiation and surgical treatment of cancer patients could lead to the progression of the tumor process and lead to the death of the patient. In connection with the current situation, doctors had to quickly change the tactics of managing cancer patients, due to the lack of accurate data on the basis of which it is possible to determine the optimal approach to the use of therapy, they had to make decisions in conditions of lack of data. The article shows an example of the treatment of 113 patients being treated in the department of surgical treatment of bone and soft tissue tumors in National Medical Research Radiological Center of the Ministry of Health of Russia during the first wave of the pandemic from March 30 to July 1, 2020. Surgical treatment was performed in 103 patients. During the period of stay in the hospital, 11 patients showed signs of coronavirus infection. Of these, 10 patients were diagnosed with coronavirus infection in the postoperative period. According to the study, the nosocomial incidence of COVID-19 is 10%. With timely diagnosis and specialized treatment, the survival rate was 100% in the given example. Consequently, if epidemiological measures are observed at all stages of hospitalization, it is possible to carry out planned surgical treatment for patients with primary and secondary lesions of bones and soft tissues. However, the decision to carry out a planned operation during a pandemic should be individual for each patient.

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Management of orthopedic oncology patients during coronavirus pandemic

Cited by 9 publications

References 13 publications

Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study

Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study

Mortality of high‐risk orthopaedic oncology patients during the COVID‐19 pandemic: A prospective cohort study

Experience of the department of surgical treatment of bone and soft tissue tumors during COVID-19 pandemic period

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