Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic review
Aims: A systematic literature review focusing on how long before surgery concurrent viral or bacterial infections (respiratory and urinary infections) should be treated in hip fracture patients, and if there is evidence for delaying this surgery. Methods: A total of 11 databases were examined using...
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2020-12-01
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| Series: | Bone & Joint Research |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.912.BJR-2019-0045.R4 |
| _version_ | 1819074716817686528 |
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| author | Enrique Guerado Juan Ramon Cano Joana Pons-Palliser |
| author_facet | Enrique Guerado Juan Ramon Cano Joana Pons-Palliser |
| author_sort | Enrique Guerado |
| collection | DOAJ |
| description | Aims: A systematic literature review focusing on how long before surgery concurrent viral or bacterial infections (respiratory and urinary infections) should be treated in hip fracture patients, and if there is evidence for delaying this surgery. Methods: A total of 11 databases were examined using the COre, Standard, Ideal (COSI) protocol. Bibliographic searches (no chronological or linguistic restriction) were conducted using, among other methods, the Patient, Intervention, Comparison, Outcome (PICO) template. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for flow diagram and checklist. Final reading of the complete texts was conducted in English, French, and Spanish. Classification of papers was completed within five levels of evidence (LE). Results: There were a total of 621 hits (526 COre; 95 Standard, Ideal) for screening identification, and 107 records were screened. Overall 67 full-text articles were assessed for eligibility, and 21 articles were included for the study question. A total of 46 full-text articles were excluded with reasons. No studies could be included in quantitative synthesis (meta-analyses), and there were many confounding variables including surgeons’ experience, prosthesis models used, and surgical technique. Conclusion: Patients with hip fracture and with a viral infection in the upper respiratory tract or without major clinical symptoms should be operated on as soon as possible (LE: I-III). There is no evidence that patients with coronavirus disease 2019 (COVID-19) should be treated differently. In relation to pneumonia, its prevention is a major issue. Antibiotics should be administered if surgery is delayed by > 72 hours or if bacterial infection is present in the lower respiratory tract (LE: III-V). In patients with hip fracture and urinary tract infection (UTI), delaying surgery may provoke further complications (LE: I). However, diabetic or immunocompromised patients may benefit from immediate antibiotic treatment. |
| first_indexed | 2024-12-21T18:13:57Z |
| format | Article |
| id | doaj.art-6a862b6a77a54fbc98921bb31950cf74 |
| institution | Directory Open Access Journal |
| issn | 2046-3758 |
| language | English |
| last_indexed | 2024-12-21T18:13:57Z |
| publishDate | 2020-12-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Research |
| spelling | doaj.art-6a862b6a77a54fbc98921bb31950cf742022-12-21T18:54:43ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582020-12-0191288489310.1302/2046-3758.912.BJR-2019-0045.R4Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic reviewEnrique Guerado0Juan Ramon Cano1Joana Pons-Palliser2Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Marbella, SpainDepartment of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Marbella, SpainMedical Library, Hospital Universitario Costa del Sol, University of Malaga, Marbella, SpainAims: A systematic literature review focusing on how long before surgery concurrent viral or bacterial infections (respiratory and urinary infections) should be treated in hip fracture patients, and if there is evidence for delaying this surgery. Methods: A total of 11 databases were examined using the COre, Standard, Ideal (COSI) protocol. Bibliographic searches (no chronological or linguistic restriction) were conducted using, among other methods, the Patient, Intervention, Comparison, Outcome (PICO) template. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for flow diagram and checklist. Final reading of the complete texts was conducted in English, French, and Spanish. Classification of papers was completed within five levels of evidence (LE). Results: There were a total of 621 hits (526 COre; 95 Standard, Ideal) for screening identification, and 107 records were screened. Overall 67 full-text articles were assessed for eligibility, and 21 articles were included for the study question. A total of 46 full-text articles were excluded with reasons. No studies could be included in quantitative synthesis (meta-analyses), and there were many confounding variables including surgeons’ experience, prosthesis models used, and surgical technique. Conclusion: Patients with hip fracture and with a viral infection in the upper respiratory tract or without major clinical symptoms should be operated on as soon as possible (LE: I-III). There is no evidence that patients with coronavirus disease 2019 (COVID-19) should be treated differently. In relation to pneumonia, its prevention is a major issue. Antibiotics should be administered if surgery is delayed by > 72 hours or if bacterial infection is present in the lower respiratory tract (LE: III-V). In patients with hip fracture and urinary tract infection (UTI), delaying surgery may provoke further complications (LE: I). However, diabetic or immunocompromised patients may benefit from immediate antibiotic treatment.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.912.BJR-2019-0045.R4hip fractureinfectionurinary tract infectionpneumoniahip arthroplasty |
| spellingShingle | Enrique Guerado Juan Ramon Cano Joana Pons-Palliser Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic review Bone & Joint Research hip fracture infection urinary tract infection pneumonia hip arthroplasty |
| title | Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic review |
| title_full | Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic review |
| title_fullStr | Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic review |
| title_full_unstemmed | Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic review |
| title_short | Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?: a systematic review |
| title_sort | should concurrent viral including covid 19 or bacterial infections be treated before performing surgery for hip fracture a systematic review |
| topic | hip fracture infection urinary tract infection pneumonia hip arthroplasty |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.912.BJR-2019-0045.R4 |
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