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Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery

INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic disease has imposed an unprecedented degree of stress on healthcare systems. This study aimed to understand whether COVID-19 positivity is associated with an increased risk of adverse outcomes after geriatric hip fracture surgery. METHODS: From...

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Autores principales: Galivanche, Anoop R., Mercier, Michael R., Schneble, Christopher A., Brand, Jordan, Pathak, Neil, Varthi, Arya G., Rubin, Lee E., Grauer, Jonathan N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522872/
https://www.ncbi.nlm.nih.gov/pubmed/34653097
http://dx.doi.org/10.5435/JAAOSGlobal-D-21-00104
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author Galivanche, Anoop R.
Mercier, Michael R.
Schneble, Christopher A.
Brand, Jordan
Pathak, Neil
Varthi, Arya G.
Rubin, Lee E.
Grauer, Jonathan N.
author_facet Galivanche, Anoop R.
Mercier, Michael R.
Schneble, Christopher A.
Brand, Jordan
Pathak, Neil
Varthi, Arya G.
Rubin, Lee E.
Grauer, Jonathan N.
author_sort Galivanche, Anoop R.
collection PubMed
description INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic disease has imposed an unprecedented degree of stress on healthcare systems. This study aimed to understand whether COVID-19 positivity is associated with an increased risk of adverse outcomes after geriatric hip fracture surgery. METHODS: From a national administrative claims data set, patients who underwent hip fracture surgery from April 1, 2020, to December 1, 2020 were selected for analysis. COVID-19–positive status was assessed by the emergency International Classification of Diagnoses, 10th Revision, COVID-19 code within 2 weeks before the surgery. Demographic, comorbidity, and 30-day postoperative adverse event information were extracted. Logistic regression before and after 10:1 propensity matching was performed to identify patient risk factors associated with the occurrence of postoperative adverse events. RESULTS: Of 42,002 patients who underwent hip fracture surgery, 678 (1.61%) were identified to be positive for COVID-19 infection. No significant differences in age, sex, and procedure type were found between COVID-19–positive and COVID-19–negative groups, but the COVID-19–positive patients demonstrated a higher incidence of several comorbidities. These differences were no longer significant after matching. After matching, the COVID-19–positive group had a higher incidence of any, serious, and minor adverse events (P < 0.001 for all). Controlling for preoperative variables, COVID-19 positivity was associated with an increased risk of experiencing any adverse events (odds ratio [OR] = 1.62, 95% confidence interval [95% CI] = [1.37 to 1.92], P < 0.001), serious adverse events (OR = 1.66, 95% CI = [1.31 to 2.07], P < 0.001), and minor adverse events (OR = 1.59, 95% CI = [1.34 to 1.89], P < 0.001). DISCUSSION: After matching and controlling for confounding variables, COVID-19–positive hip fracture patients had increased odds of multiple postoperative events. Clinicians caring for this vulnerable geriatric population should be mindful of this risk to improve the care for these patients during the ongoing global pandemic.
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spelling pubmed-85228722021-10-19 Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery Galivanche, Anoop R. Mercier, Michael R. Schneble, Christopher A. Brand, Jordan Pathak, Neil Varthi, Arya G. Rubin, Lee E. Grauer, Jonathan N. J Am Acad Orthop Surg Glob Res Rev Research Article INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic disease has imposed an unprecedented degree of stress on healthcare systems. This study aimed to understand whether COVID-19 positivity is associated with an increased risk of adverse outcomes after geriatric hip fracture surgery. METHODS: From a national administrative claims data set, patients who underwent hip fracture surgery from April 1, 2020, to December 1, 2020 were selected for analysis. COVID-19–positive status was assessed by the emergency International Classification of Diagnoses, 10th Revision, COVID-19 code within 2 weeks before the surgery. Demographic, comorbidity, and 30-day postoperative adverse event information were extracted. Logistic regression before and after 10:1 propensity matching was performed to identify patient risk factors associated with the occurrence of postoperative adverse events. RESULTS: Of 42,002 patients who underwent hip fracture surgery, 678 (1.61%) were identified to be positive for COVID-19 infection. No significant differences in age, sex, and procedure type were found between COVID-19–positive and COVID-19–negative groups, but the COVID-19–positive patients demonstrated a higher incidence of several comorbidities. These differences were no longer significant after matching. After matching, the COVID-19–positive group had a higher incidence of any, serious, and minor adverse events (P < 0.001 for all). Controlling for preoperative variables, COVID-19 positivity was associated with an increased risk of experiencing any adverse events (odds ratio [OR] = 1.62, 95% confidence interval [95% CI] = [1.37 to 1.92], P < 0.001), serious adverse events (OR = 1.66, 95% CI = [1.31 to 2.07], P < 0.001), and minor adverse events (OR = 1.59, 95% CI = [1.34 to 1.89], P < 0.001). DISCUSSION: After matching and controlling for confounding variables, COVID-19–positive hip fracture patients had increased odds of multiple postoperative events. Clinicians caring for this vulnerable geriatric population should be mindful of this risk to improve the care for these patients during the ongoing global pandemic. Wolters Kluwer 2021-10-15 /pmc/articles/PMC8522872/ /pubmed/34653097 http://dx.doi.org/10.5435/JAAOSGlobal-D-21-00104 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Galivanche, Anoop R.
Mercier, Michael R.
Schneble, Christopher A.
Brand, Jordan
Pathak, Neil
Varthi, Arya G.
Rubin, Lee E.
Grauer, Jonathan N.
Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
title Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
title_full Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
title_fullStr Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
title_full_unstemmed Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
title_short Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
title_sort clinical characteristics and perioperative complication profiles of covid-19–positive patients undergoing hip fracture surgery
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522872/
https://www.ncbi.nlm.nih.gov/pubmed/34653097
http://dx.doi.org/10.5435/JAAOSGlobal-D-21-00104
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