Rate of COVID-19 infection and 30 day mortality between blue and green (dedicated COVID-19 safe) pathways: Results from phase 1 and 2 of the UK foot and ankle COVID-19 national (UK-FAlCoN) audit
The primary aim was to determine the differences in COVID-19 infection rate and 30-day mortality in patients undergoing foot and ankle surgery between different treatment pathways over the two phases of the UK-FALCON audit, spanning the first and second UK national lockdowns. This was an ambispectiv...
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| creator | Malhotra, Karan Mangwani, Jitendra Houchen-Wollof, Linzy Mason, Lyndon W. |
| description | The primary aim was to determine the differences in COVID-19 infection rate and 30-day mortality in patients undergoing foot and ankle surgery between different treatment pathways over the two phases of the UK-FALCON audit, spanning the first and second UK national lockdowns.
This was an ambispective (retrospective Phase 1 and prospective Phase 2) national audit of foot and ankle procedures in the UK in 2020 completed between 13th January 2020 and 30th November 2020.
All adult patients undergoing foot and ankle surgery in an operating theatre during the study period were included from 46 participating centres in England, Scotland, Wales and Northern Ireland. Patients were categorised as either a green pathway (designated COVID-19 free) or blue pathway (no protocols to prevent COVID-19 infection).
10,846 patients were included, 6644 from phase 1 and 4202 from phase 2. Over the 2 phases the infection rate on a blue pathway was 1.07% (69/6470) and 0.21% on a green pathway (9/4280). In phase 1, there was no significant difference in the COVID-19 perioperative infection rate between the blue and green pathways in any element of the first phase (pre-lockdown (p = .109), lockdown (p = .923) or post-lockdown (p = .577)). However, in phase 2 there was a significant reduction in perioperative infection rate when using the green pathway in both the pre-lockdown (p |
| doi_str_mv | 10.1016/j.fas.2022.02.017 |
| format | Article |
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This was an ambispective (retrospective Phase 1 and prospective Phase 2) national audit of foot and ankle procedures in the UK in 2020 completed between 13th January 2020 and 30th November 2020.
All adult patients undergoing foot and ankle surgery in an operating theatre during the study period were included from 46 participating centres in England, Scotland, Wales and Northern Ireland. Patients were categorised as either a green pathway (designated COVID-19 free) or blue pathway (no protocols to prevent COVID-19 infection).
10,846 patients were included, 6644 from phase 1 and 4202 from phase 2. Over the 2 phases the infection rate on a blue pathway was 1.07% (69/6470) and 0.21% on a green pathway (9/4280). In phase 1, there was no significant difference in the COVID-19 perioperative infection rate between the blue and green pathways in any element of the first phase (pre-lockdown (p = .109), lockdown (p = .923) or post-lockdown (p = .577)). However, in phase 2 there was a significant reduction in perioperative infection rate when using the green pathway in both the pre-lockdown (p < .001) and lockdown periods (Odd’s Ratio 0.077, p < .001). There was no significant difference in COVID-19 related mortality between pathways.
There was a five-fold reduction in the perioperative COVID-19 infection rate when using designated COVID-19 green pathways over the whole study period; however the success of the pathways only became significant in phase 2 of the study, where there was a 13-fold reduction in infection rate. The study shows a developing success to using green pathways in reducing the risk to patients undergoing foot and ankle surgery.</description><identifier>ISSN: 1268-7731</identifier><identifier>ISSN: 1460-9584</identifier><identifier>EISSN: 1460-9584</identifier><identifier>DOI: 10.1016/j.fas.2022.02.017</identifier><identifier>PMID: 35256273</identifier><language>eng</language><publisher>France: Elsevier Ltd</publisher><subject>Adult ; Ankle - surgery ; Communicable Disease Control ; COVID-19 ; COVID-19 - epidemiology ; Foot and ankle surgery ; Humans ; Mortality ; National audit ; Pathways ; Prospective Studies ; Retrospective Studies ; SARS-Cov-2 ; UK-FALCON ; United Kingdom - epidemiology</subject><ispartof>Foot and ankle surgery, 2022-10, Vol.28 (7), p.1055-1063</ispartof><rights>2022 European Foot and Ankle Society</rights><rights>Copyright © 2022 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.</rights><rights>2022 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved. 2022 European Foot and Ankle Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c403t-d0e3a9a2f6bea745fc8c5df091de74b514a65066a46d565bff4643bfad27a11c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1268773122000455$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35256273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Malhotra, Karan</creatorcontrib><creatorcontrib>Mangwani, Jitendra</creatorcontrib><creatorcontrib>Houchen-Wollof, Linzy</creatorcontrib><creatorcontrib>Mason, Lyndon W.</creatorcontrib><creatorcontrib>UK – FalCoN Audit Collaborators</creatorcontrib><title>Rate of COVID-19 infection and 30 day mortality between blue and green (dedicated COVID-19 safe) pathways: Results from phase 1 and 2 of the UK foot and ankle COVID-19 national (UK-FAlCoN) audit</title><title>Foot and ankle surgery</title><addtitle>Foot Ankle Surg</addtitle><description>The primary aim was to determine the differences in COVID-19 infection rate and 30-day mortality in patients undergoing foot and ankle surgery between different treatment pathways over the two phases of the UK-FALCON audit, spanning the first and second UK national lockdowns.
This was an ambispective (retrospective Phase 1 and prospective Phase 2) national audit of foot and ankle procedures in the UK in 2020 completed between 13th January 2020 and 30th November 2020.
All adult patients undergoing foot and ankle surgery in an operating theatre during the study period were included from 46 participating centres in England, Scotland, Wales and Northern Ireland. Patients were categorised as either a green pathway (designated COVID-19 free) or blue pathway (no protocols to prevent COVID-19 infection).
10,846 patients were included, 6644 from phase 1 and 4202 from phase 2. Over the 2 phases the infection rate on a blue pathway was 1.07% (69/6470) and 0.21% on a green pathway (9/4280). In phase 1, there was no significant difference in the COVID-19 perioperative infection rate between the blue and green pathways in any element of the first phase (pre-lockdown (p = .109), lockdown (p = .923) or post-lockdown (p = .577)). However, in phase 2 there was a significant reduction in perioperative infection rate when using the green pathway in both the pre-lockdown (p < .001) and lockdown periods (Odd’s Ratio 0.077, p < .001). There was no significant difference in COVID-19 related mortality between pathways.
There was a five-fold reduction in the perioperative COVID-19 infection rate when using designated COVID-19 green pathways over the whole study period; however the success of the pathways only became significant in phase 2 of the study, where there was a 13-fold reduction in infection rate. The study shows a developing success to using green pathways in reducing the risk to patients undergoing foot and ankle surgery.</description><subject>Adult</subject><subject>Ankle - surgery</subject><subject>Communicable Disease Control</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Foot and ankle surgery</subject><subject>Humans</subject><subject>Mortality</subject><subject>National audit</subject><subject>Pathways</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>SARS-Cov-2</subject><subject>UK-FALCON</subject><subject>United Kingdom - epidemiology</subject><issn>1268-7731</issn><issn>1460-9584</issn><issn>1460-9584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kd9u0zAUhyMEYmPwANwgX24XKXYS2w1ISFNhMG1i0kS5tU7s49UljYvtbOrr8WS47djgBsmS__3O5yN_RfGa0QmjTLxdTizESUWrakLzYPJJccgaQcuWT5uneV2JaSllzQ6KFzEuKaWypfXz4qDmFReVrA-LX9eQkHhLZlffzz-WrCVusKiT8wOBwZCaEgMbsvIhQe_ShnSY7hAH0vUj7hI3Ybs9NmiczizzSIpg8YSsIS3uYBPfkWuMY58iscGvyHoBEQnbIaptA2mBZH5BrPdpdwjDjx4fYQNse4KeHM8vyrPTfua_nhAYjUsvi2cW-oiv7uejYn726dvsS3l59fl8dnpZ6obWqTQUa2ihsqJDkA23eqq5sbRlBmXTcdaA4FQIaIThgnfWNqKpOwumksCYro-KD3vueuxWaDQOKUCv1sGtIGyUB6f-vRncQt34WzWdykrSJgOO7wHB_xwxJrVyUWPfw4B-jKoSdXbFZctzlO2jOvgYA9qHZxhVW_dqqbJ7tXWvaB5M5po3f_f3UPFHdg683wcw_9Ktw6CidjjobC5k5cp49x_8b6mevjg</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Malhotra, Karan</creator><creator>Mangwani, Jitendra</creator><creator>Houchen-Wollof, Linzy</creator><creator>Mason, Lyndon W.</creator><general>Elsevier Ltd</general><general>European Foot and Ankle Society. Published by Elsevier Ltd</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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20221001</creationdate><title>Rate of COVID-19 infection and 30 day mortality between blue and green (dedicated COVID-19 safe) pathways: Results from phase 1 and 2 of the UK foot and ankle COVID-19 national (UK-FAlCoN) audit</title><author>Malhotra, Karan ; Mangwani, Jitendra ; Houchen-Wollof, Linzy ; Mason, Lyndon W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-d0e3a9a2f6bea745fc8c5df091de74b514a65066a46d565bff4643bfad27a11c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Ankle - surgery</topic><topic>Communicable Disease Control</topic><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>Foot and ankle surgery</topic><topic>Humans</topic><topic>Mortality</topic><topic>National audit</topic><topic>Pathways</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>SARS-Cov-2</topic><topic>UK-FALCON</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Malhotra, Karan</creatorcontrib><creatorcontrib>Mangwani, Jitendra</creatorcontrib><creatorcontrib>Houchen-Wollof, Linzy</creatorcontrib><creatorcontrib>Mason, Lyndon W.</creatorcontrib><creatorcontrib>UK – FalCoN Audit Collaborators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Foot and ankle surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Malhotra, Karan</au><au>Mangwani, Jitendra</au><au>Houchen-Wollof, Linzy</au><au>Mason, Lyndon W.</au><aucorp>UK – FalCoN Audit Collaborators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rate of COVID-19 infection and 30 day mortality between blue and green (dedicated COVID-19 safe) pathways: Results from phase 1 and 2 of the UK foot and ankle COVID-19 national (UK-FAlCoN) audit</atitle><jtitle>Foot and ankle surgery</jtitle><addtitle>Foot Ankle Surg</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>28</volume><issue>7</issue><spage>1055</spage><epage>1063</epage><pages>1055-1063</pages><issn>1268-7731</issn><issn>1460-9584</issn><eissn>1460-9584</eissn><abstract>The primary aim was to determine the differences in COVID-19 infection rate and 30-day mortality in patients undergoing foot and ankle surgery between different treatment pathways over the two phases of the UK-FALCON audit, spanning the first and second UK national lockdowns.
This was an ambispective (retrospective Phase 1 and prospective Phase 2) national audit of foot and ankle procedures in the UK in 2020 completed between 13th January 2020 and 30th November 2020.
All adult patients undergoing foot and ankle surgery in an operating theatre during the study period were included from 46 participating centres in England, Scotland, Wales and Northern Ireland. Patients were categorised as either a green pathway (designated COVID-19 free) or blue pathway (no protocols to prevent COVID-19 infection).
10,846 patients were included, 6644 from phase 1 and 4202 from phase 2. Over the 2 phases the infection rate on a blue pathway was 1.07% (69/6470) and 0.21% on a green pathway (9/4280). In phase 1, there was no significant difference in the COVID-19 perioperative infection rate between the blue and green pathways in any element of the first phase (pre-lockdown (p = .109), lockdown (p = .923) or post-lockdown (p = .577)). However, in phase 2 there was a significant reduction in perioperative infection rate when using the green pathway in both the pre-lockdown (p < .001) and lockdown periods (Odd’s Ratio 0.077, p < .001). There was no significant difference in COVID-19 related mortality between pathways.
There was a five-fold reduction in the perioperative COVID-19 infection rate when using designated COVID-19 green pathways over the whole study period; however the success of the pathways only became significant in phase 2 of the study, where there was a 13-fold reduction in infection rate. The study shows a developing success to using green pathways in reducing the risk to patients undergoing foot and ankle surgery.</abstract><cop>France</cop><pub>Elsevier Ltd</pub><pmid>35256273</pmid><doi>10.1016/j.fas.2022.02.017</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1268-7731 |
| ispartof | Foot and ankle surgery, 2022-10, Vol.28 (7), p.1055-1063 |
| issn | 1268-7731 1460-9584 1460-9584 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8872704 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Ankle - surgery Communicable Disease Control COVID-19 COVID-19 - epidemiology Foot and ankle surgery Humans Mortality National audit Pathways Prospective Studies Retrospective Studies SARS-Cov-2 UK-FALCON United Kingdom - epidemiology |
| title | Rate of COVID-19 infection and 30 day mortality between blue and green (dedicated COVID-19 safe) pathways: Results from phase 1 and 2 of the UK foot and ankle COVID-19 national (UK-FAlCoN) audit |
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