Elsevier

The Surgeon

Volume 19, Issue 5, October 2021, Pages e256-e264
The Surgeon

Outcomes of orthopaedic trauma patients undergoing surgery during the peak period of COVID-19 infection at a UK major trauma centre

https://doi.org/10.1016/j.surge.2020.11.009Get rights and content

Highlights

  • 22% of the population were COVID-19 positive at any time point.

  • The overall mortality and complication rates for the population were 4% and 14% respectively.

  • Complication rates were higher in those who were COVID-19 positive, over 70 with hip fractures.

  • Conversely those who were under 70 and COVID-19 negative had lower complication rates.

Abstract

Background

To review the clinical outcomes of all patients undergoing emergency orthopaedic trauma surgery at a UK major trauma centre during the first 6 weeks of the COVID-19 related lockdown.

Methods

A retrospective review was performed of all patients who underwent emergency orthopaedic trauma surgery at a single urban major trauma centre over the first six-week period of national lockdown. Demographics, co-morbidities, injuries, injury severity scores, surgery, COVID-19 status, complications and mortalities were analysed.

Results

A total of 76 patients were included for review who underwent multiple procedures. Significant co-morbidity was present in 72%. The overall COVID-19 infection rate of the study population at any time was 22%. Sub-group analysis indicated 13% had active COVID-19 at the time of surgery. Only 4% of patients developed COVID-19 post surgery with no mortalities in this sub-group. The overall mortality rate was 4%. The overall complication rate was 14%. However mortality and complications rates were higher if the patients had active COVID-19 at surgery, if they were over 70 years and had sustained life-threatening injuries.

Conclusion

The overall survival rate for patients undergoing emergency orthopaedic trauma surgery during the COVID-19 peak was 96%. The rate of any complication was more significant in those presenting with active COVID-19 infections who had sustained potentially life threatening injuries and were over 70 years of age. Conversely those without active COVID-19 infection and who lacked significant co-morbidities experienced a lower complication and mortality rate.

Keywords

COVID-19
Orthopaedic trauma surgery
Outcomes

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