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The rate of COVID-19 and associated mortality after elective hip and knee arthroplasty prior to cessation of elective services in UK
- Source :
- 2021, ' The rate of COVID-19 and associated mortality after elective hip and knee arthroplasty prior to cessation of elective services in UK : A multicentre study conducted during March 2020 ', Bone and Joint Journal, vol. 103-B, no. 4, pp. 681-688 . https://doi.org/10.1302/0301-620X.103B.BJJ-2020-1776.R1
- Publication Year :
- 2021
- Publisher :
- British Editorial Society of Bone & Joint Surgery, 2021.
-
Abstract
- Aims The primary aim was to assess the rate of postoperative COVID-19 following hip and knee arthroplasty performed in March 2020 in the UK. The secondary aims were to assess whether there were clinical factors associated with COVID-19 status, the mortality rate of patients with COVID-19, and the rate of potential COVID-19 in patients not presenting to healthcare services. Methods A multicentre retrospective study was conducted of patients undergoing hip or knee arthroplasty during the first wave of the COVID-19 pandemic (1 March 2020 to 31 March 2020) with a minimum of 60 days follow-up. Patient demographics, American Society of Anesthesiologists grade, procedure type, primary or revision, length of stay (LOS), COVID-19 test status, and postoperative mortality were recorded. A subgroup of patients (n = 211) who had not presented to healthcare services after discharge were contacted and questioned as to whether they had symptoms of COVID-19. Results Five (0.5%) of 1,073 patients who underwent hip or knee arthroplasty tested positive for SARS-CoV-2 postoperatively. When adjusting for confounding factors, increasing LOS (p = 0.022) was the only significant factor associated with developing COVID-19 following surgery and a stay greater than three days was a reliable predictor with an area under the curve of 81% (p = 0.018). There were three (0.3%) deaths in the study cohort and the overall mortality rate attributable to COVID-19 was 0.09% (n = 1/1,073), with one (20%) of the five patients with COVID-19 dying postoperatively. Of the 211 patients contacted, two had symptoms within two to 14 days postoperatively with a positive predictive value of 31% and it was therefore estimated that one patient may have had undiagnosed COVID-19. Conclusion The rate of postoperative COVID-19 was 0.5% and may have been as high as 1% when accounting for those patients not presenting to healthcare services, which was similar to the estimated population prevalence during the study period. The overall mortality rate secondary to COVID-19 was low (0.09%), however the mortality rate for those patients developing COVID-19 was 20%. Cite this article: Bone Joint J 2021;103-B(4):681–688.
- Subjects :
- Adult
Male
Clinical audit
medicine.medical_specialty
COVID-19/diagnosis
Arthroplasty, Replacement, Hip
medicine.medical_treatment
Population
Sensitivity and Specificity
Health Services Accessibility
03 medical and health sciences
symbols.namesake
COVID-19 Testing
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Orthopedics and Sports Medicine
030212 general & internal medicine
Arthroplasty, Replacement, Knee
education
Fisher's exact test
Aged
Retrospective Studies
Aged, 80 and over
030222 orthopedics
education.field_of_study
Clinical Audit
United Kingdom/epidemiology
business.industry
Mortality rate
Retrospective cohort study
Postoperative Complications/diagnosis
Middle Aged
Survival Analysis
Arthroplasty
Elective Surgical Procedures
Cohort
symbols
Female
Surgery
Elective Surgical Procedure
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 20494408 and 20494394
- Database :
- OpenAIRE
- Journal :
- The Bone & Joint Journal
- Accession number :
- edsair.doi.dedup.....721f9b5ebd5796c7db25ddd1f24831c0
- Full Text :
- https://doi.org/10.1302/0301-620x.103b.bjj-2020-1776.r1