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Oktober 14, 2021


INCREASED PERIOPERATIVE MORBIDITY, MORTALITY IN PATIENTS WHO HAD COVID-19 WITHIN
1 MONTH OF UNDERGOING ORTHOPAEDIC SURGERY


By Erika Powers

VIRTUAL -- October 14, 2021 -- Among patients undergoing planned or emergency
orthopaedic surgery, the rate of postoperative oxygen requirements, pneumonia,
and mortality were significantly higher among those who had tested positive for
coronavirus disease 2019 (COVID-19) within the 30 days prior to surgery than
those without, according to a study presented at Anesthesiology 2021, the Annual
Meeting of the American Society of Anesthesiologists (ASA).

There were also statistically significant differences in length of stay and
readmission within 1 month of discharge between both cohorts

“Throughout the pandemic in New York City, urgent and emergent orthopaedic
procedures were performed at our institution, despite the lack of evidence to
guide perioperative decision-making,” explained Uchenna Umeh, MD, New York
University Langone Health, New York, New York. “We wanted to understand how
COVID-19 infection affected mortality, perioperative complication rates, and
hospital metrics for patients undergoing orthopaedic procedures requiring
anaesthesia care.”

To do so, the researchers analysed data from 51 patients who tested positive for
COVID-19 within 1 month before undergoing orthopaedic surgery, between March 1,
2020, and June 30, 2020. Patients were matched with a similar cohort of patients
who underwent orthopaedic surgery between October 1, 2019, and December 21,
2019.

Postoperative pneumonia occurred in 12 (23.5%) patients in the COVID-19 cohort
compared with none in the matched control group (P = .0005). Postoperative
oxygen requirement also occurred at a significantly higher rate in the COVID-19
group (33.3% vs 13.3%; P = .01).

There were 8 (15.7%) deaths in the COVID-19 group compared with 1 (19%) in the
control group (P = .02).

Length of stay ((8.10 ± 9.01 days vs 4.59 ± 4.69 days; P = 0.002) and
readmission within 1 month of discharge (38.8% vs 8.2%; P = .0006) were
significantly higher in the COVID-19 cohort.

When analysing preoperative variables and postoperative outcomes, the
researchers found that diabetes and hypertension lead to worse outcomes in the
COVID-19 cohort. Emergency surgery led to worse outcomes for both groups.

“These results confirm the deleterious effects of COVID-19 on cardiopulmonary
function,” said Dr. Umeh. “It is important to consider the risks associated with
COVID-19 infection during the pre-surgical and perioperative phases.”

[Presentation title: Increased Perioperative Morbidity and Mortality in COVID-19
Patients Undergoing Orthopedic Surgery. Abstract JS01]
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R. Donnelly geantwortet am Mi, 20/10/2021 - 08:26 Permanenter Link

would this not make a case for elective vaccination in all patients undergoing
elective THR and TKR?
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