Is it safe to perform elective orthopaedic surgery with high community rates of COVID-19? An observational cohort study
During the first wave of the COVID-19 pandemic, University Hospitals Birmingham NHS Foundation trust was able to recommence elective orthopaedic surgery using private hospitals procured by the NHS as COVID-19 free 'green' sites. We report on the safety of elective orthopaedic surgery with...
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| Veröffentlicht in: | Annals of the Royal College of Surgeons of England 2021-06, Vol.103 (6), p.415-419 |
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| container_title | Annals of the Royal College of Surgeons of England |
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| creator | Dickenson, E J Jordan, R W Poole, C Shyamalan, G Arbuthnot, J Makrides, P Smith, N A |
| description | During the first wave of the COVID-19 pandemic, University Hospitals Birmingham NHS Foundation trust was able to recommence elective orthopaedic surgery using private hospitals procured by the NHS as COVID-19 free 'green' sites. We report on the safety of elective orthopaedic surgery with high rates of community transmission.
We conducted an observational cohort study on consecutive NHS patients attending three private hospitals between 4 May 2020 and 16 June 2020. Patients attended preoperative assessment, including coronavirus disease (COVID-19) symptom screening, were instructed to self-isolate for 14 days and had a negative COVID-19 swab within 72 hours of surgery. Patient age, American Society of Anesthesiologists (ASA) grade, body mass index, surgery performed, type of anaesthetic and length of stay were collected. Our primary outcome was a positive COVID-19 swab, secondary outcomes were COVID-19 symptoms, readmission, surgical complications and mortality.
Between 4 May 2020 and 16 June 2020, 191 patients were admitted to three private hospitals for elective surgery; 121 (67%) patients underwent general or regional anaesthetic, 179 patients were ASA grades 1 or 2 (94%) and 12 (6%) were ASA 3. In total, 187 (98%) patients were successfully contacted at 30 days postoperative and no COVID-19 symptoms, positive COVID-19 swabs or mortality or were recorded. One patient was readmitted following a pulmonary embolism and two patients were treated as outpatients for a deep vein thrombosis and a superficial infection.
With 'green pathways' elective orthopaedic surgery can safely be performed while rates of COVID-19 in the community are high. |
| doi_str_mv | 10.1308/rcsann.2020.7141 |
| format | Article |
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We conducted an observational cohort study on consecutive NHS patients attending three private hospitals between 4 May 2020 and 16 June 2020. Patients attended preoperative assessment, including coronavirus disease (COVID-19) symptom screening, were instructed to self-isolate for 14 days and had a negative COVID-19 swab within 72 hours of surgery. Patient age, American Society of Anesthesiologists (ASA) grade, body mass index, surgery performed, type of anaesthetic and length of stay were collected. Our primary outcome was a positive COVID-19 swab, secondary outcomes were COVID-19 symptoms, readmission, surgical complications and mortality.
Between 4 May 2020 and 16 June 2020, 191 patients were admitted to three private hospitals for elective surgery; 121 (67%) patients underwent general or regional anaesthetic, 179 patients were ASA grades 1 or 2 (94%) and 12 (6%) were ASA 3. In total, 187 (98%) patients were successfully contacted at 30 days postoperative and no COVID-19 symptoms, positive COVID-19 swabs or mortality or were recorded. One patient was readmitted following a pulmonary embolism and two patients were treated as outpatients for a deep vein thrombosis and a superficial infection.
With 'green pathways' elective orthopaedic surgery can safely be performed while rates of COVID-19 in the community are high.</description><identifier>ISSN: 0035-8843</identifier><identifier>EISSN: 1478-7083</identifier><identifier>DOI: 10.1308/rcsann.2020.7141</identifier><identifier>PMID: 34058122</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Aged, 80 and over ; Body mass index ; Cohort analysis ; Communicable Disease Control - methods ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 - prevention & control ; Cross Infection - prevention & control ; Elective Surgical Procedures - adverse effects ; Electronic records ; Female ; Hospitals ; Humans ; Length of stay ; Male ; Middle Aged ; Mortality ; Observational studies ; Orthopedic Procedures - adverse effects ; Orthopedics ; Pandemics ; Patients ; Population ; Surgery ; Surgical outcomes ; Trauma and Orthopaedics ; Young Adult</subject><ispartof>Annals of the Royal College of Surgeons of England, 2021-06, Vol.103 (6), p.415-419</ispartof><rights>Copyright Royal College of Surgeons of England Jun 2021</rights><rights>Copyright © 2021, All rights reserved by the Royal College of Surgeons of England 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-de55a7f476923a12510b25b979b65b71e89dd2deb710f3626adf7e1758d79c113</citedby><cites>FETCH-LOGICAL-c425t-de55a7f476923a12510b25b979b65b71e89dd2deb710f3626adf7e1758d79c113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10335252/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10335252/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,725,778,782,883,27911,27912,53778,53780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34058122$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dickenson, E J</creatorcontrib><creatorcontrib>Jordan, R W</creatorcontrib><creatorcontrib>Poole, C</creatorcontrib><creatorcontrib>Shyamalan, G</creatorcontrib><creatorcontrib>Arbuthnot, J</creatorcontrib><creatorcontrib>Makrides, P</creatorcontrib><creatorcontrib>Smith, N A</creatorcontrib><title>Is it safe to perform elective orthopaedic surgery with high community rates of COVID-19? An observational cohort study</title><title>Annals of the Royal College of Surgeons of England</title><addtitle>Ann R Coll Surg Engl</addtitle><description>During the first wave of the COVID-19 pandemic, University Hospitals Birmingham NHS Foundation trust was able to recommence elective orthopaedic surgery using private hospitals procured by the NHS as COVID-19 free 'green' sites. We report on the safety of elective orthopaedic surgery with high rates of community transmission.
We conducted an observational cohort study on consecutive NHS patients attending three private hospitals between 4 May 2020 and 16 June 2020. Patients attended preoperative assessment, including coronavirus disease (COVID-19) symptom screening, were instructed to self-isolate for 14 days and had a negative COVID-19 swab within 72 hours of surgery. Patient age, American Society of Anesthesiologists (ASA) grade, body mass index, surgery performed, type of anaesthetic and length of stay were collected. Our primary outcome was a positive COVID-19 swab, secondary outcomes were COVID-19 symptoms, readmission, surgical complications and mortality.
Between 4 May 2020 and 16 June 2020, 191 patients were admitted to three private hospitals for elective surgery; 121 (67%) patients underwent general or regional anaesthetic, 179 patients were ASA grades 1 or 2 (94%) and 12 (6%) were ASA 3. In total, 187 (98%) patients were successfully contacted at 30 days postoperative and no COVID-19 symptoms, positive COVID-19 swabs or mortality or were recorded. One patient was readmitted following a pulmonary embolism and two patients were treated as outpatients for a deep vein thrombosis and a superficial infection.
With 'green pathways' elective orthopaedic surgery can safely be performed while rates of COVID-19 in the community are high.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body mass index</subject><subject>Cohort analysis</subject><subject>Communicable Disease Control - methods</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - prevention & control</subject><subject>Cross Infection - prevention & control</subject><subject>Elective Surgical Procedures - adverse effects</subject><subject>Electronic records</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Length of stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Orthopedic Procedures - adverse effects</subject><subject>Orthopedics</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Population</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Trauma and Orthopaedics</subject><subject>Young Adult</subject><issn>0035-8843</issn><issn>1478-7083</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkU1v1DAQhi0EotvCnROyxIVLFn_GzqmqFgorVeoFuFqOPdm4SuLFdrbaf09WWyrgNCPNM69m9CD0jpI15UR_Si7baVozwshaUUFfoBUVSleKaP4SrQjhstJa8At0mfMDIbRRmr5GF1wQqSljK_S4zTgUnG0HuES8h9TFNGIYwJVwABxT6ePegg8O5zntIB3xYyg97sOuxy6O4zyFcsTJFsg4dnhz_3P7uaLNNb6ZcGwzpIMtIU52WOh-icO5zP74Br3q7JDh7VO9Qj9uv3zffKvu7r9uNzd3lRNMlsqDlFZ1QtUN45YySUnLZNuopq1lqyjoxnvmYWlJx2tWW98poEpqrxpHKb9C1-fc_dyO4B1MJdnB7FMYbTqaaIP5dzKF3uziwVDCuWSSLQkfnxJS_DVDLmYM2cEw2AninA2TXGpeC6oW9MN_6EOc0_L6iRJc1UTIZqHImXIp5pyge76GEnPSas5azUmrOWldVt7__cXzwh-P_DcRpqBZ</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Dickenson, E J</creator><creator>Jordan, R W</creator><creator>Poole, C</creator><creator>Shyamalan, G</creator><creator>Arbuthnot, J</creator><creator>Makrides, P</creator><creator>Smith, N A</creator><general>BMJ Publishing Group LTD</general><general>Royal College of Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>EHMNL</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202106</creationdate><title>Is it safe to perform elective orthopaedic surgery with high community rates of COVID-19? 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An observational cohort study</atitle><jtitle>Annals of the Royal College of Surgeons of England</jtitle><addtitle>Ann R Coll Surg Engl</addtitle><date>2021-06</date><risdate>2021</risdate><volume>103</volume><issue>6</issue><spage>415</spage><epage>419</epage><pages>415-419</pages><issn>0035-8843</issn><eissn>1478-7083</eissn><abstract>During the first wave of the COVID-19 pandemic, University Hospitals Birmingham NHS Foundation trust was able to recommence elective orthopaedic surgery using private hospitals procured by the NHS as COVID-19 free 'green' sites. We report on the safety of elective orthopaedic surgery with high rates of community transmission.
We conducted an observational cohort study on consecutive NHS patients attending three private hospitals between 4 May 2020 and 16 June 2020. Patients attended preoperative assessment, including coronavirus disease (COVID-19) symptom screening, were instructed to self-isolate for 14 days and had a negative COVID-19 swab within 72 hours of surgery. Patient age, American Society of Anesthesiologists (ASA) grade, body mass index, surgery performed, type of anaesthetic and length of stay were collected. Our primary outcome was a positive COVID-19 swab, secondary outcomes were COVID-19 symptoms, readmission, surgical complications and mortality.
Between 4 May 2020 and 16 June 2020, 191 patients were admitted to three private hospitals for elective surgery; 121 (67%) patients underwent general or regional anaesthetic, 179 patients were ASA grades 1 or 2 (94%) and 12 (6%) were ASA 3. In total, 187 (98%) patients were successfully contacted at 30 days postoperative and no COVID-19 symptoms, positive COVID-19 swabs or mortality or were recorded. One patient was readmitted following a pulmonary embolism and two patients were treated as outpatients for a deep vein thrombosis and a superficial infection.
With 'green pathways' elective orthopaedic surgery can safely be performed while rates of COVID-19 in the community are high.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>34058122</pmid><doi>10.1308/rcsann.2020.7141</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Aged Aged, 80 and over Body mass index Cohort analysis Communicable Disease Control - methods Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control Cross Infection - prevention & control Elective Surgical Procedures - adverse effects Electronic records Female Hospitals Humans Length of stay Male Middle Aged Mortality Observational studies Orthopedic Procedures - adverse effects Orthopedics Pandemics Patients Population Surgery Surgical outcomes Trauma and Orthopaedics Young Adult |
| title | Is it safe to perform elective orthopaedic surgery with high community rates of COVID-19? An observational cohort study |
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