Details der Publikation - Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures

Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures : an international cohort study

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ..

OBJECTIVES: Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.

SETTING: Prospective, international, multicentre, observational cohort study.

PARTICIPANTS: Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).

PRIMARY OUTCOME: 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.

RESULTS: This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).

CONCLUSIONS: Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.

TRIAL REGISTRATION NUMBER: NCT04323644.

Medienart:	E-Artikel

Erscheinungsjahr:	2021
Erschienen:	2021

Enthalten in:	Zur Gesamtaufnahme - volume:11
Enthalten in:	BMJ open - 11(2021), 11 vom: 30. Nov., Seite e050830

Sprache:	Englisch

Beteiligte Personen:	COVIDSurg Collaborative [VerfasserIn] Khatri, Chetan [Sonstige Person] Ward, A E [Sonstige Person] Nepogodiev, D [Sonstige Person] Ahmed, I [Sonstige Person] Chaudhry, D [Sonstige Person] Dhaif, F [Sonstige Person] Bankhad-Kendall, B [Sonstige Person] Kaafarani, H [Sonstige Person] Bretherton, C [Sonstige Person] Mahmood, A [Sonstige Person] Marais, L [Sonstige Person] Parsons, N [Sonstige Person] Bhangu, A [Sonstige Person] Metcalfe, Andrew [Sonstige Person] Siaw-Acheampong, K [Sonstige Person] Chaudhry, D [Sonstige Person] Dawson, B E [Sonstige Person] Evans, J P [Sonstige Person] Glasbey, J C [Sonstige Person] Gujjuri, R R [Sonstige Person] Heritage, E [Sonstige Person] Jones, C S [Sonstige Person] Kamarajah, S K [Sonstige Person] Keatley, J M [Sonstige Person] Lawday, S [Sonstige Person] Li, E [Sonstige Person] Mckay, S C [Sonstige Person] Nepogodiev, D [Sonstige Person] Pellino, G [Sonstige Person] Tiwari, A [Sonstige Person] Simoes, J F F [Sonstige Person] Trout, I M [Sonstige Person] Venn, M L [Sonstige Person] Wilkin, R J W [Sonstige Person] Bhangu, A [Sonstige Person] Ademuyiwa, A O [Sonstige Person] Agarwal, A [Sonstige Person] Al Ameer, E [Sonstige Person] Alderson, D [Sonstige Person] Alser, O [Sonstige Person] Arnaud, A P [Sonstige Person] Augestad, K M [Sonstige Person] Bankhead-Kendall, B [Sonstige Person] Benson, R A [Sonstige Person] Chakrabortee, S [Sonstige Person] Blanco-Colino, R [Sonstige Person] Brar, A [Sonstige Person] Minaya Bravo, A [Sonstige Person] Breen, K A [Sonstige Person] Lima Buarque, I [Sonstige Person] Caruana, E [Sonstige Person] Cunha, M F [Sonstige Person] Davidson, G H [Sonstige Person] Desai, A [Sonstige Person] Di Saverio, S [Sonstige Person] Edwards, J [Sonstige Person] Elhadi, M [Sonstige Person] Farik, S [Sonstige Person] Fiore, M [Sonstige Person] Fitzgerald, J E [Sonstige Person] Ford, S [Sonstige Person] Gallo, G [Sonstige Person] Ghosh, D [Sonstige Person] Gomes, G M A [Sonstige Person] Griffiths, E [Sonstige Person] Halkias, C [Sonstige Person] Harrison, E M [Sonstige Person] Hutchinson, P [Sonstige Person] Isik, A [Sonstige Person] Kaafarani, H [Sonstige Person] Kolias, A [Sonstige Person] Lawani, I [Sonstige Person] Lederhuber, H [Sonstige Person] Leventoglu, S [Sonstige Person] Loffler, M W [Sonstige Person] Martin, J [Sonstige Person] Mashbari, H [Sonstige Person] Mazingi, D [Sonstige Person] Mohan, H [Sonstige Person] Moore, R [Sonstige Person] Moszkowicz, D [Sonstige Person] Ng-Kamstra, J S [Sonstige Person] Metallidis, S [Sonstige Person] Moug, S [Sonstige Person] Niquen, M [Sonstige Person] Ntirenganya, F [Sonstige Person] Outani, O [Sonstige Person] Pata, F [Sonstige Person] Pinkney, T D [Sonstige Person] Pockney, P [Sonstige Person] Radenkovic, D [Sonstige Person] Ramos-De la Medina, A [Sonstige Person] Roberts, K [Sonstige Person] Santos, I [Sonstige Person] Schache, A [Sonstige Person] Schnitzbauer, A [Sonstige Person] Stewart, G D [Sonstige Person] Shaw, R [Sonstige Person] Shu, S [Sonstige Person] Soreide, K [Sonstige Person]

Links:	Volltext

Themen:	COVID-19 Hip Journal Article Observational Study Research Support, Non-U.S. Gov't Trauma management

Anmerkungen:	Date Completed 03.12.2021 Date Revised 04.04.2024 published: Electronic ClinicalTrials.gov: NCT04323644 Citation Status MEDLINE

doi:	10.1136/bmjopen-2021-050830

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM333855329

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245	1	0	\|a Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures \|b an international cohort study
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500			\|a Date Revised 04.04.2024
500			\|a published: Electronic
500			\|a ClinicalTrials.gov: NCT04323644
500			\|a Citation Status MEDLINE
520			\|a © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
520			\|a OBJECTIVES: Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis
520			\|a SETTING: Prospective, international, multicentre, observational cohort study
520			\|a PARTICIPANTS: Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative)
520			\|a PRIMARY OUTCOME: 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality
520			\|a RESULTS: This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787)
520			\|a CONCLUSIONS: Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups
520			\|a TRIAL REGISTRATION NUMBER: NCT04323644
650		4	\|a Journal Article
650		4	\|a Observational Study
650		4	\|a Research Support, Non-U.S. Gov't
650		4	\|a COVID-19
650		4	\|a hip
650		4	\|a trauma management
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700	1		\|a Ahmed, I \|e investigator \|4 oth
700	1		\|a Chaudhry, D \|e investigator \|4 oth
700	1		\|a Dhaif, F \|e investigator \|4 oth
700	1		\|a Bankhad-Kendall, B \|e investigator \|4 oth
700	1		\|a Kaafarani, H \|e investigator \|4 oth
700	1		\|a Bretherton, C \|e investigator \|4 oth
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700	1		\|a Marais, L \|e investigator \|4 oth
700	1		\|a Parsons, N \|e investigator \|4 oth
700	1		\|a Bhangu, A \|e investigator \|4 oth
700	1		\|a Metcalfe, Andrew \|e investigator \|4 oth
700	1		\|a Siaw-Acheampong, K \|e investigator \|4 oth
700	1		\|a Chaudhry, D \|e investigator \|4 oth
700	1		\|a Dawson, B E \|e investigator \|4 oth
700	1		\|a Evans, J P \|e investigator \|4 oth
700	1		\|a Glasbey, J C \|e investigator \|4 oth
700	1		\|a Gujjuri, R R \|e investigator \|4 oth
700	1		\|a Heritage, E \|e investigator \|4 oth
700	1		\|a Jones, C S \|e investigator \|4 oth
700	1		\|a Kamarajah, S K \|e investigator \|4 oth
700	1		\|a Keatley, J M \|e investigator \|4 oth
700	1		\|a Lawday, S \|e investigator \|4 oth
700	1		\|a Li, E \|e investigator \|4 oth
700	1		\|a Mckay, S C \|e investigator \|4 oth
700	1		\|a Nepogodiev, D \|e investigator \|4 oth
700	1		\|a Pellino, G \|e investigator \|4 oth
700	1		\|a Tiwari, A \|e investigator \|4 oth
700	1		\|a Simoes, J F F \|e investigator \|4 oth
700	1		\|a Trout, I M \|e investigator \|4 oth
700	1		\|a Venn, M L \|e investigator \|4 oth
700	1		\|a Wilkin, R J W \|e investigator \|4 oth
700	1		\|a Bhangu, A \|e investigator \|4 oth
700	1		\|a Ademuyiwa, A O \|e investigator \|4 oth
700	1		\|a Agarwal, A \|e investigator \|4 oth
700	1		\|a Al Ameer, E \|e investigator \|4 oth
700	1		\|a Alderson, D \|e investigator \|4 oth
700	1		\|a Alser, O \|e investigator \|4 oth
700	1		\|a Arnaud, A P \|e investigator \|4 oth
700	1		\|a Augestad, K M \|e investigator \|4 oth
700	1		\|a Bankhead-Kendall, B \|e investigator \|4 oth
700	1		\|a Benson, R A \|e investigator \|4 oth
700	1		\|a Chakrabortee, S \|e investigator \|4 oth
700	1		\|a Blanco-Colino, R \|e investigator \|4 oth
700	1		\|a Brar, A \|e investigator \|4 oth
700	1		\|a Minaya Bravo, A \|e investigator \|4 oth
700	1		\|a Breen, K A \|e investigator \|4 oth
700	1		\|a Lima Buarque, I \|e investigator \|4 oth
700	1		\|a Caruana, E \|e investigator \|4 oth
700	1		\|a Cunha, M F \|e investigator \|4 oth
700	1		\|a Davidson, G H \|e investigator \|4 oth
700	1		\|a Desai, A \|e investigator \|4 oth
700	1		\|a Di Saverio, S \|e investigator \|4 oth
700	1		\|a Edwards, J \|e investigator \|4 oth
700	1		\|a Elhadi, M \|e investigator \|4 oth
700	1		\|a Farik, S \|e investigator \|4 oth
700	1		\|a Fiore, M \|e investigator \|4 oth
700	1		\|a Fitzgerald, J E \|e investigator \|4 oth
700	1		\|a Ford, S \|e investigator \|4 oth
700	1		\|a Gallo, G \|e investigator \|4 oth
700	1		\|a Ghosh, D \|e investigator \|4 oth
700	1		\|a Gomes, G M A \|e investigator \|4 oth
700	1		\|a Griffiths, E \|e investigator \|4 oth
700	1		\|a Halkias, C \|e investigator \|4 oth
700	1		\|a Harrison, E M \|e investigator \|4 oth
700	1		\|a Hutchinson, P \|e investigator \|4 oth
700	1		\|a Isik, A \|e investigator \|4 oth
700	1		\|a Kaafarani, H \|e investigator \|4 oth
700	1		\|a Kolias, A \|e investigator \|4 oth
700	1		\|a Lawani, I \|e investigator \|4 oth
700	1		\|a Lederhuber, H \|e investigator \|4 oth
700	1		\|a Leventoglu, S \|e investigator \|4 oth
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700	1		\|a Mazingi, D \|e investigator \|4 oth
700	1		\|a Mohan, H \|e investigator \|4 oth
700	1		\|a Moore, R \|e investigator \|4 oth
700	1		\|a Moszkowicz, D \|e investigator \|4 oth
700	1		\|a Ng-Kamstra, J S \|e investigator \|4 oth
700	1		\|a Metallidis, S \|e investigator \|4 oth
700	1		\|a Moug, S \|e investigator \|4 oth
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700	1		\|a Ntirenganya, F \|e investigator \|4 oth
700	1		\|a Outani, O \|e investigator \|4 oth
700	1		\|a Pata, F \|e investigator \|4 oth
700	1		\|a Pinkney, T D \|e investigator \|4 oth
700	1		\|a Pockney, P \|e investigator \|4 oth
700	1		\|a Radenkovic, D \|e investigator \|4 oth
700	1		\|a Ramos-De la Medina, A \|e investigator \|4 oth
700	1		\|a Roberts, K \|e investigator \|4 oth
700	1		\|a Santos, I \|e investigator \|4 oth
700	1		\|a Schache, A \|e investigator \|4 oth
700	1		\|a Schnitzbauer, A \|e investigator \|4 oth
700	1		\|a Stewart, G D \|e investigator \|4 oth
700	1		\|a Shaw, R \|e investigator \|4 oth
700	1		\|a Shu, S \|e investigator \|4 oth
700	1		\|a Soreide, K \|e investigator \|4 oth
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures : an international cohort study

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