30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemic
<p><strong>Introduction:</strong><br /> The aim of this study is to report the 30 day COVID-19 related morbidity and mortality of patients assessed as SARS-CoV-2 negative who underwent emergency or urgent orthopaedic surgery in the NHS during the peak of the COVID-19 pandemic...
| Main Authors: | , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
British Editorial Society of Bone and Joint Surgery
2020
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| _version_ | 1797051015191592960 |
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| author | Price, A Shearman, AD Hamilton, TW Alvand, A Kendrick, B |
| author2 | COVID-19 NOC Surgical Team |
| author_facet | COVID-19 NOC Surgical Team Price, A Shearman, AD Hamilton, TW Alvand, A Kendrick, B |
| author_sort | Price, A |
| collection | OXFORD |
| description | <p><strong>Introduction:</strong><br />
The aim of this study is to report the 30 day COVID-19 related morbidity and mortality of patients assessed as SARS-CoV-2 negative who underwent emergency or urgent orthopaedic surgery in the NHS during the peak of the COVID-19 pandemic.</p><br />
<p><strong>Method:</strong><br />
A retrospective, single centre, observational cohort study of all patients undergoing surgery between 17 March 2020 and 3May 2020 was performed. Outcomes were stratified by British Orthopaedic Association COVID-19 Patient Risk Assessment Tool. Patients who were SARS-CoV-2 positive at the time of surgery were excluded.</p><br />
<p><strong>Results:</strong><br />
Overall, 96 patients assessed as negative for SARS-CoV-2 at the time of surgery underwent 100 emergency or urgent orthopaedic procedures during the study period. Within 30 days of surgery 9.4% of patients (n = 9) were found to be SARS-CoV-2 positive by nasopharyngeal swab. The overall 30 day mortality rate across the whole cohort of patients during this period was 3% (n = 3). Of those testing positive for SARS-CoV-2 66% (n = 6) developed significant COVID-19 related complications and there was a 33% 30-day mortality rate (n = 3). Overall, the 30-day mortality in patients classified as BOA low or medium risk (n = 69) was 0%, whereas in those classified as high or very high risk (n = 27) it was 11.1%.</p><br />
<p><strong>Conclusion:</strong><br />
Orthopaedic surgery in SARS-CoV-2 negative patients who transition to positive within 30 days of surgery carries a significant risk of morbidity and mortality. In lower risk groups, the overall risk of becoming SARS-CoV-2 positive, and subsequently developing a significant postoperative related complication, was low even during the peak of the pandemic. In addition to ensuring patients are SARS-CoV-2 negative at the time of surgery it is important that the risk of acquiring SARS-CoV-2 is minimized through their recovery.</p> |
| first_indexed | 2024-03-06T18:13:47Z |
| format | Journal article |
| id | oxford-uuid:03e64c18-5ec4-49ad-9dc7-57a7e081c89a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:13:47Z |
| publishDate | 2020 |
| publisher | British Editorial Society of Bone and Joint Surgery |
| record_format | dspace |
| spelling | oxford-uuid:03e64c18-5ec4-49ad-9dc7-57a7e081c89a2022-03-26T08:48:57Z30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemicJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:03e64c18-5ec4-49ad-9dc7-57a7e081c89aEnglishSymplectic ElementsBritish Editorial Society of Bone and Joint Surgery2020Price, AShearman, ADHamilton, TWAlvand, AKendrick, BCOVID-19 NOC Surgical Team<p><strong>Introduction:</strong><br /> The aim of this study is to report the 30 day COVID-19 related morbidity and mortality of patients assessed as SARS-CoV-2 negative who underwent emergency or urgent orthopaedic surgery in the NHS during the peak of the COVID-19 pandemic.</p><br /> <p><strong>Method:</strong><br /> A retrospective, single centre, observational cohort study of all patients undergoing surgery between 17 March 2020 and 3May 2020 was performed. Outcomes were stratified by British Orthopaedic Association COVID-19 Patient Risk Assessment Tool. Patients who were SARS-CoV-2 positive at the time of surgery were excluded.</p><br /> <p><strong>Results:</strong><br /> Overall, 96 patients assessed as negative for SARS-CoV-2 at the time of surgery underwent 100 emergency or urgent orthopaedic procedures during the study period. Within 30 days of surgery 9.4% of patients (n = 9) were found to be SARS-CoV-2 positive by nasopharyngeal swab. The overall 30 day mortality rate across the whole cohort of patients during this period was 3% (n = 3). Of those testing positive for SARS-CoV-2 66% (n = 6) developed significant COVID-19 related complications and there was a 33% 30-day mortality rate (n = 3). Overall, the 30-day mortality in patients classified as BOA low or medium risk (n = 69) was 0%, whereas in those classified as high or very high risk (n = 27) it was 11.1%.</p><br /> <p><strong>Conclusion:</strong><br /> Orthopaedic surgery in SARS-CoV-2 negative patients who transition to positive within 30 days of surgery carries a significant risk of morbidity and mortality. In lower risk groups, the overall risk of becoming SARS-CoV-2 positive, and subsequently developing a significant postoperative related complication, was low even during the peak of the pandemic. In addition to ensuring patients are SARS-CoV-2 negative at the time of surgery it is important that the risk of acquiring SARS-CoV-2 is minimized through their recovery.</p> |
| spellingShingle | Price, A Shearman, AD Hamilton, TW Alvand, A Kendrick, B 30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemic |
| title | 30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemic |
| title_full | 30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemic |
| title_fullStr | 30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemic |
| title_full_unstemmed | 30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemic |
| title_short | 30-day outcome after orthopaedic surgery in patients assessed as negative for COVID-19 at the time of surgery during the peak of the pandemic |
| title_sort | 30 day outcome after orthopaedic surgery in patients assessed as negative for covid 19 at the time of surgery during the peak of the pandemic |
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