Mortality risk of surgically managing orthopaedic trauma during the COVID-19 pandemic. (21st May 2021)

• Record Type: Journal Article
• Authors: Balakumar, Balasubramanian; Nandra, Rajpal S.; Woffenden, Hugo; Atkin, Benjamin; Mahmood, Ansar; Cooper, George; Cooper, Julian; Hindle, Paul
• Is Part Of: Bone & joint open. Volume 2:Number 5(2021)
• Page Start: 330
• Page End: 336
• Publication Date: 2021-05-21
• Subjects: Morbidity -- Mortality -- COVID-19 -- Trauma -- Surgery -- Orthopaedics; Orthopedic surgery -- Periodicals; Musculoskeletal system -- Surgery -- Periodicals; 617.47
• DOI: 10.1302/2633-1462.25.BJO-2020-0189.R1
• Languages: English
• ISSNs: 2633-1462

Abstract

Abstract : Aims: It is imperative to understand the risks of operating on urgent cases during the COVID-19 (SARS-Cov-2 virus) pandemic for clinical decision-making and medical resource planning. The primary aim was to determine the mortality risk and associated variables when operating on urgent cases during the COVID-19 pandemic. The secondary objective was to assess differences in the outcome of patients treated between sites treating COVID-19 and a separate surgical site. Methods: The primary outcome measure was 30-day mortality. Secondary measures included complications of surgery, COVID-19 infection, and length of stay. Multiple variables were assessed for their contribution to the 30-day mortality. In total, 433 patients were included with a mean age of 65 years; 45% were male, and 90% were Caucasian. Results: Overall mortality was 7.6% for all patients and 15.9% for femoral neck fractures. The mortality rate increased from 7.5% to 44.2% in patients with fracture neck of femur and a COVID-19 infection. The COVID-19 rate in the 30-day postoperative period was 11%. COVID-19 infection, age, and Charlson Comorbidity Index were independent risk factor for mortality. Conclusion: There was a significant risk of contracting COVID-19 due to being admitted to hospital. Using a site which was not treating COVID-19 respiratory patients for surgery did not identify a difference with respect to mortality, nosocomial COVID-19 infection, or length of stay. The COVID-19 pandemic significantly increases perioperative mortality risk in patients with fractured neck of femora but patients with other injuries were not at increased risk. Cite this article: Bone Jt Open 2021;2(5):330–336.