Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Collaborative, COVIDSurg

doi:10.1136/bmjopen-2021-050830

Cited by 11 publications

(8 citation statements)

References 45 publications

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“… 13 , 14 , 15 , 16 , 17 , 18 , 19 This elevated risk of postoperative complications is also seen with postoperative acquisition of COVID-19 infection. 4 , 6 , 20 , 21 …”

Section: Clinical Riskmentioning

confidence: 99%

“…An additional research question is whether the type of anesthesia has a role in mitigating post-COVID-19 surgical patients’ perioperative risk. For example, one study showed no impact on mortality risk between regional or general anesthesia for patients with proximal femur fractures, 20 and case reports regarding the role of regional anesthesia are emerging. 66 Another area for future investigation is optimizing care for post-COVID-19 patients in an ambulatory (non-hospital) setting.…”

Section: Risk Mitigation and Risk Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 in the perioperative setting: A review of the literature and the clinical landscape

O’Glasser¹,

Schenning²

2022

Perioperative Care and Operating Room Management

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“… 13 , 14 , 15 , 16 , 17 , 18 , 19 This elevated risk of postoperative complications is also seen with postoperative acquisition of COVID-19 infection. 4 , 6 , 20 , 21 …”

Section: Clinical Riskmentioning

confidence: 99%

Section: Risk Mitigation and Risk Assessmentmentioning

confidence: 99%

COVID-19 in the perioperative setting: A review of the literature and the clinical landscape

O’Glasser¹,

Schenning²

2022

Perioperative Care and Operating Room Management

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“…Subsequent studies have demonstrated an elevated postoperative risk that persists for at least four weeks after the index infection, including increased mortality, pulmonary complications and venous thromboembolic events [5,[22][23][24][25][26][27]. This elevated risk of postoperative complications is also observed with the postoperative acquisition of SARS-CoV-2 infection [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Lessons Learned in Elective Surgeries After 6 Pandemic Waves of SARS‐CoV‐2. A Single European Center Experience

García‐Botella,

De la Serna Esteban,

López‐Antoñanzas

et al. 2023

World j. surg.

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Background The reported high surgical morbidity and mortality in patients with SARS-CoV-2 prompted preoperative screening and modification of surgical protocols. Although vaccination and treatment of COVID-19 have resulted in lower hospitalization rates and infection severity, publications on postoperative results have not been updated. The aim of the study was to analyze the outcomes of patients undergoing surgery in two periods with high incidence of SARS-CoV-2 infection, before and after vaccination. Materials and Methods This is a prospective cohort study of patients undergoing surgery in two periods: March-June 2020 (Group2020) and December 2021-February 2022 (Group2022) (after massive vaccination). Results In total, 618 patients who underwent surgery were included in the analysis (Group2020: 343 vs. Group2022: 275). Significantly more oncological procedures were performed in Group2020, and there were no differences in postoperative complications. Nosocomial SARS-CoV-2 infection occurred in 4 patients in Group2020 and 1 patient in Group2022. In Group 2022, 70 patients (25.4%) had COVID-19 prior to surgery, and 68 (97.1%) were vaccinated. Comparative analysis between patients with past COVID-19 and those without showed no difference in postoperative morbidity and mortality. According to the time elapsed between SARS-CoV-2 infection and surgery (B 7 or [ 7 weeks), comparative analysis showed no significant differences. Conclusion The establishment of preoperative screening protocols for SARS-CoV-2 infection results in a low incidence of nosocomial infection and optimal postoperative outcomes. Preoperative SARS-CoV-2 infection in vaccinated patients was not associated with increased postoperative complications, even in shorter periods after infection. In surgical patients, individualized preoperative evaluation after SARS-CoV-2 infection may be more important than strict time limitation.

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“…Project Auditing COVID-19 in Trauma and Orthopaedics (IMPACT) Group found that, after adjusting for confounding factors, the risk of 30-day mortality for hip fracture patients with COVID-19 was three times greater than COVID-negative patients (COVIDSurg, 2021;Hall et al, 2020;Hall & Public Health Scotland, 2021). The multinational IMPACT-Global Hip Fracture Audit demonstrated that, in the context of COVID-19 infection, increased age, male sex, frailty, and pre-existing renal and pulmonary disease were associated with an increased 30-day mortality risk (Hall, Clement, IMPACT-Global, et al, 2022;Hall, Clement, MacLullich, Simpson, Johansen, et al, 2022;.…”

Section: Findings Of Previous Studies By the International Multicentrementioning

confidence: 99%

COVID‐19 during the index hospital admission confers a ‘double‐hit’ effect on hip fracture patients and is associated with a two‐fold increase in 1‐year mortality risk

Hall

Clement

MacLullich

et al. 2022

Musculoskeletal Care

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Purpose:The aims were to: (1) determine 1-year mortality rates for hip fracture patients during the first UK COVID-19 wave, and (2) assess mortality risk associated with COVID-19. Methods:A nationwide multicentre cohort study was conducted of all patients presenting to 17 hospitals in March-April 2020. Follow-up data were collected one year after initial hip fracture ('index') admission, including: COVID-19 status, readmissions, mortality, and cause of death.Results: Data were available for 788/833 (94.6%) patients. One-year mortality was 242/788 (30.7%), and the prevalence of COVID-19 within 365 days of admission was 142/788 (18.0%). One-year mortality was higher for patients with COVID-19 (46.5% vs. 27.2%; p < 0.001), and highest for those COVID-positive during index admission versus after discharge (54.7% vs. 39.7%; p = 0.025). Anytime COVID-19 was independently associated with 50% increased mortality risk within a year of injury (HR 1.50, p = 0.006); adjusted mortality risk doubled (HR 2.03, p < 0.001) for patients COVID-positive during index admission. No independent association was observed between mortality risk and COVID-19 diagnosed following discharge (HR 1.16, p = 0.462). Most deaths (56/66; 84.8%) in COVID-positive patients occurred within 30 days of COVID-19 diagnosis (median 11.0 days). Most cases diagnosed following discharge from the admission hospital occurred in downstream hospitals. Conclusion:Almost half the patients that had COVID-19 within 365 days of fracture had died within one year of injury versus 27.2% of COVID-negative patients.Only COVID-19 diagnosed during the index admission was associated independently with an increased likelihood of death, indicating that infection during this time may represent a 'double-hit' insult, and most COVID-related deaths occurred within 30 days of diagnosis.IMPACT Revisited Group collaborative authors are listed in Appendix section.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Cited by 11 publications

References 45 publications

COVID-19 in the perioperative setting: A review of the literature and the clinical landscape

COVID-19 in the perioperative setting: A review of the literature and the clinical landscape

Lessons Learned in Elective Surgeries After 6 Pandemic Waves of SARS‐CoV‐2. A Single European Center Experience

COVID‐19 during the index hospital admission confers a ‘double‐hit’ effect on hip fracture patients and is associated with a two‐fold increase in 1‐year mortality risk

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