Orthopaedic Surgical Selection and Inpatient Paradigms During the Coronavirus (COVID-19) Pandemic

Massey, Patrick A.; McClary, Kaylan N.; Zhang, Andrew S; Savoie, Felix H.; Barton, R. Shane

doi:10.5435/jaaos-d-20-00360

Cited by 124 publications

(176 citation statements)

References 24 publications

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“…All health services have had to reconfigure the way care is delivered to patients and their families and the implications for surgical services during the current outbreak and in the subsequent “post‐pandemic” era are concerning and equally unclear 6‐9 . Organ transplantation is an exemplar model of complex major surgery with an additional challenge of managing immunosuppressed patients and the constant scarcity of organs.…”

Section: Introductionmentioning

confidence: 99%

Organ donation during the COVID-19 pandemic

Ahmed

Brockmeier²,

Lee³

et al. 2020

American Journal of Transplantation

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The coronavirus disease 2019 (COVID‐19) pandemic is a rapidly changing circumstance with dramatic policy changes and universal efforts to deal with the initial crisis and minimize its consequences. To identify changes to organ donation and transplantation during this time, an anonymous web‐based survey was distributed to 19 select organ procurement organizations (OPOs) throughout the United States comparing 90‐day activity during March‐May 2020 and March‐May 2019. Seventeen OPOs responded to the survey (response rate of 89.5%). Organ authorization decreased by 11% during the current pandemic (n = 1379 vs n = 1552, P = .0001). Organ recovery for transplantation fell by 17% (P = .0001) with a further 18% decrease in the number of organs transplanted (P = .0001). Donor cause of death demonstrated a 4.5% decline in trauma but a 35% increase in substance abuse cases during the COVID‐19 period. All OPOs reported significant modifications in response to the pandemic, limiting the onsite presence of staff and transitioning to telephonic approaches for donor family correspondence. Organ donation during the current climate has seen significant changes and the long‐term implications of such shifts remain unclear. These trends during the COVID‐19 era warrant further investigation to address unmet needs, plan for a proportionate response to the virus and mitigate the collateral impact.

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Section: Introductionmentioning

confidence: 99%

Organ donation during the COVID-19 pandemic

Ahmed

Brockmeier²,

Lee³

et al. 2020

American Journal of Transplantation

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“…Having said that, changes to inpatient and outpatient care have been accordingly tailored to reduce the risk of contamination in patients, medical staff and to allow hospitals to free up beds for treatment of patients with positive or suspected COVID-19 [4,5]. All elective surgical procedures should be cancelled and deferred until an opportune time [6]. Trauma cases surgeries should continue to proceed.…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic surgeons’ perceptions on COVID-19 related changes in practice: an international survey

Meraghni¹,

Bouyoucef²,

Soal³

et al. 2020

Preprint

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Purpose The purpose of this study was to assess the orthopaedic surgeons’ perceptions on COVID-19 related changes in their practice.MethodsAn online survey was shared with orthopaedic surgeons practicing in different countries.ResultsThis study showed that orthopaedic surgery plan management was adapted to respond more effectively to the COVID-19 pandemic while maintaining the continuity of health care and ensuring protection of medical staff and patients. Among the introduced measures, elective surgery was postponed to free-up beds for suspected or COVID-19 positive patients requiring hospitalization. Additionally, the number of outpatient visits was considerably decreased and non-urgent visits were postponed to reduce the flow of patients in and out of hospitals and therefore minimize the risk of contamination. Interestingly, data revealed the willingness of orthopaedic surgeons to take care of COVID-19 positive patients and support their colleagues in intensive care units, if needed.ConclusionsThough, orthopaedic surgeons are not in the frontline, they have an important role to play to face the increasing pressure due to the COVID-19 pandemic. In addition to the changes imposed in their current practice, they have a role in providing support to other colleagues in the fight against this global crisis.

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“…To clarify the urgency of orthopedic surgery, we have categorized orthopedic surgeries into 5 categories based on priority: Priority A (emergency surgery within 24 hours, Priority B (urgent surgery within <48 hours, Priority C (Expedited Surgery within 2 weeks), Priority D (Short-Term Delayed <3 months), and Priority E (Long-Term Delayed >3 months) [9]. The categories of Priority A and B are classi ed as orthopedic emergency, Priority C is classi ed as expedited surgery, and Priority D and E are classi ed as elective surgery.…”

Section: Data Collectionmentioning

confidence: 99%

Epidemiologic Characteristics and Double-buffered Strategy for Patients in Orthopedic Surgery During the Novel Coronavirus Outbreak: Wuhan's Experience

Zhou

Ming

Liu

2020

Preprint

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Background: The purpose of this article is to summarize the epidemiologic characteristics and double-buffered strategy for patients in orthopedic surgery during the COVID-19 outbreak in Wuhan, China, based on our own experience in our hospital. Methods: A retrospective and comparative study was performed to identify all inpatients at our clinic from February 17, 2020 to April 20, 2020 (epidemic group), and from February 17, 2019 to April 20, 2019 (control group). Epidemiologic characteristics, screening effect, perioperative complications, and nosocomial infection were analyzed. Results: In the epidemic group, 82 patients were identified, a decrease by 76.0% than the 342 patients in the same period in the 2019. Patients in the epidemic group (54.6 ± 20.2 years) were older than those in the control group (49.6 ± 22.5 years). For the epidemic group, the proportion rates of traumatic factures (69.5%) and low-energy injuries (86.0%) were higher than that in the control group, respectively (35.4% and 37.2%). The preoperative waiting time (7.0 ± 2.6 days) in the epidemic group was longer than that in the control group (4.5 ± 2.1 days). The postoperative complication rate (12.2%) in the epidemic group was higher than that in the control group (3.5%). No nosocomial infection of orthopedic staff and patients with COVID-19 was noted in the epidemic group.Conclusion: During the COVID-19 outbreak in Wuhan, China, orthopedic inpatients showed unique epidemiological characteristics. The double-buffered strategy could effectively avoid nosocomial infections among medical staff and patients. Doctors should fully evaluate the perioperative risks and complications.

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Orthopaedic Surgical Selection and Inpatient Paradigms During the Coronavirus (COVID-19) Pandemic

Cited by 124 publications

References 24 publications

Organ donation during the COVID-19 pandemic

Organ donation during the COVID-19 pandemic

Orthopaedic surgeons’ perceptions on COVID-19 related changes in practice: an international survey

Epidemiologic Characteristics and Double-buffered Strategy for Patients in Orthopedic Surgery During the Novel Coronavirus Outbreak: Wuhan's Experience

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