Is it safe to perform elective orthopaedic surgery with high community rates of COVID-19? An observational cohort study.

Dickenson, E J, Jordan, R W, Poole, C, Shyamalan, G, Arbuthnot, J, Makrides, Panayiotis and Smith, N A (2021) Is it safe to perform elective orthopaedic surgery with high community rates of COVID-19? An observational cohort study. Annals of the Royal College of Surgeons of England, 103 (6). pp. 415-419. ISSN 1478-7083. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://www.rcseng.ac.uk/publications/annals/

Abstract

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSION

With 'green pathways' elective orthopaedic surgery can safely be performed while rates of COVID-19 in the community are high.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WC Communicabable diseases
WE Musculoskeletal. Orthopaedics
WO Surgery
Divisions: Planned IP Care > Trauma and Orthopaedics
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 09 Jun 2021 11:07
Last Modified: 09 Jun 2021 11:07
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4417

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