Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the first wave of the COVID-19 pandemic: it was safe to perform orthopaedic procedures at our hospital during the first COVID-19 peak. Waters, R, Dey, R, Laubscher, M, Dunn, R, Maqungo, S, McCollum, G, Nortje, M, Roche, S, Hilton, T, Mugla, W, & Held, M South African Medical Journal, 111(8):747–752, aug, 2021. ![Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the first wave of the COVID-19 pandemic: it was safe to perform orthopaedic procedures at our hospital during the first COVID-19 peak [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Background. Initial local and global evidence suggests that SARS-CoV-2-infected patients who undergo surgery, and those who become infected perioperatively, have an increased mortality risk post surgery. Objectives. To analyse and describe the 30-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection rates of patients, both SARS-CoV-2-positive and negative, undergoing orthopaedic surgery at a tertiary academic hospital in South Africa (SA) during the first COVID-19 peak. Methods. This single-centre, observational, prospective study included patients who underwent orthopaedic procedures from 1 April 2020 (beginning of the COVID-19 case increase in SA) to 31 July 2020 (first COVID-19 peak in SA). All patients were screened for COVID-19 and were confirmed positive if they had a positive laboratory quantitative polymerase chain reaction test for SARS-CoV-2 RNA on a nasopharyngeal or oral swab. Thirty-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection were assessed. Results. Overall, a total of 433 operations were performed on 346 patients during the timeframe. Of these patients, 65.9% ( n =228) were male and 34.1% ( n =118) were female. The mean (standard deviation) age was 42.5 (16.8) years (range 9 - 89). Of the patients, 5 (1.4%) were identified as COVID-19 patients under investigation (PUI) on admission and tested positive for SARS-CoV-2 before surgery, and 1 (0.3%) contracted SARS-CoV-2 perioperatively; all survived 30 days post surgery. Twenty-nine patients were lost to follow-up, and data were missing for 6 patients. The final analysis was performed excluding these 35 patients. Of the 311 patients included in the final 30-day mortality analysis, 303 (97%) had a follow-up observation ≥30 days after the operation. The overall 30-day mortality for these patients was 2.5% ( n =8 deaths). None of the recorded deaths were of screened COVID-19 PUI. Conclusions. We report a low 30-day mortality rate of 2.5% ( n =8) for patients undergoing orthopaedic surgery at our hospital during the first COVID-19 peak. None of the deaths were COVID-19 related, and all patients who tested SARS-CoV-2-positive, before or after surgery, survived. Our overall 30-day mortality rate correlates with several other reports of orthopaedic centres analysing over similar timeframes during the first peak of the COVID-19 pandemic. Regarding mortality and SARS-CoV-2 infection risk, we can conclude that with the appropriate measures taken, it was safe to undergo orthopaedic procedures at our hospital during the first peak of the COVID-19 pandemic in SA.
@article{Waters2021a,
abstract = {Background. Initial local and global evidence suggests that SARS-CoV-2-infected patients who undergo surgery, and those who become infected perioperatively, have an increased mortality risk post surgery. Objectives. To analyse and describe the 30-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection rates of patients, both SARS-CoV-2-positive and negative, undergoing orthopaedic surgery at a tertiary academic hospital in South Africa (SA) during the first COVID-19 peak. Methods. This single-centre, observational, prospective study included patients who underwent orthopaedic procedures from 1 April 2020 (beginning of the COVID-19 case increase in SA) to 31 July 2020 (first COVID-19 peak in SA). All patients were screened for COVID-19 and were confirmed positive if they had a positive laboratory quantitative polymerase chain reaction test for SARS-CoV-2 RNA on a nasopharyngeal or oral swab. Thirty-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection were assessed. Results. Overall, a total of 433 operations were performed on 346 patients during the timeframe. Of these patients, 65.9{\%} ( n =228) were male and 34.1{\%} ( n =118) were female. The mean (standard deviation) age was 42.5 (16.8) years (range 9 - 89). Of the patients, 5 (1.4{\%}) were identified as COVID-19 patients under investigation (PUI) on admission and tested positive for SARS-CoV-2 before surgery, and 1 (0.3{\%}) contracted SARS-CoV-2 perioperatively; all survived 30 days post surgery. Twenty-nine patients were lost to follow-up, and data were missing for 6 patients. The final analysis was performed excluding these 35 patients. Of the 311 patients included in the final 30-day mortality analysis, 303 (97{\%}) had a follow-up observation ≥30 days after the operation. The overall 30-day mortality for these patients was 2.5{\%} ( n =8 deaths). None of the recorded deaths were of screened COVID-19 PUI. Conclusions. We report a low 30-day mortality rate of 2.5{\%} ( n =8) for patients undergoing orthopaedic surgery at our hospital during the first COVID-19 peak. None of the deaths were COVID-19 related, and all patients who tested SARS-CoV-2-positive, before or after surgery, survived. Our overall 30-day mortality rate correlates with several other reports of orthopaedic centres analysing over similar timeframes during the first peak of the COVID-19 pandemic. Regarding mortality and SARS-CoV-2 infection risk, we can conclude that with the appropriate measures taken, it was safe to undergo orthopaedic procedures at our hospital during the first peak of the COVID-19 pandemic in SA.},
author = {Waters, R and Dey, R and Laubscher, M and Dunn, R and Maqungo, S and McCollum, G and Nortje, M and Roche, S and Hilton, T and Mugla, W and Held, M},
doi = {10.7196/SAMJ.2021.V111I8.15766},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Waters et al. - 2021 - Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the.pdf:pdf},
issn = {2078-5135},
journal = {South African Medical Journal},
keywords = {19,2,30,30-day mortality,COVID,COVID-19,CoV,Diagnosis,Infection,OA,Orthopaedic,SARS,SARS-CoV-2,Safety,Surgery,Survival,day mortality,fund{\_}not{\_}ack,original},
mendeley-tags = {OA,fund{\_}not{\_}ack,original},
month = {aug},
number = {8},
pages = {747--752},
pmid = {35227355},
title = {{Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the first wave of the COVID-19 pandemic: it was safe to perform orthopaedic procedures at our hospital during the first COVID-19 peak}},
url = {http://www.samj.org.za/index.php/samj/article/view/13361},
volume = {111},
year = {2021}
}
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To analyse and describe the 30-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection rates of patients, both SARS-CoV-2-positive and negative, undergoing orthopaedic surgery at a tertiary academic hospital in South Africa (SA) during the first COVID-19 peak. Methods. This single-centre, observational, prospective study included patients who underwent orthopaedic procedures from 1 April 2020 (beginning of the COVID-19 case increase in SA) to 31 July 2020 (first COVID-19 peak in SA). All patients were screened for COVID-19 and were confirmed positive if they had a positive laboratory quantitative polymerase chain reaction test for SARS-CoV-2 RNA on a nasopharyngeal or oral swab. Thirty-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection were assessed. Results. Overall, a total of 433 operations were performed on 346 patients during the timeframe. Of these patients, 65.9% ( n =228) were male and 34.1% ( n =118) were female. The mean (standard deviation) age was 42.5 (16.8) years (range 9 - 89). Of the patients, 5 (1.4%) were identified as COVID-19 patients under investigation (PUI) on admission and tested positive for SARS-CoV-2 before surgery, and 1 (0.3%) contracted SARS-CoV-2 perioperatively; all survived 30 days post surgery. Twenty-nine patients were lost to follow-up, and data were missing for 6 patients. The final analysis was performed excluding these 35 patients. Of the 311 patients included in the final 30-day mortality analysis, 303 (97%) had a follow-up observation ≥30 days after the operation. The overall 30-day mortality for these patients was 2.5% ( n =8 deaths). None of the recorded deaths were of screened COVID-19 PUI. Conclusions. We report a low 30-day mortality rate of 2.5% ( n =8) for patients undergoing orthopaedic surgery at our hospital during the first COVID-19 peak. None of the deaths were COVID-19 related, and all patients who tested SARS-CoV-2-positive, before or after surgery, survived. Our overall 30-day mortality rate correlates with several other reports of orthopaedic centres analysing over similar timeframes during the first peak of the COVID-19 pandemic. Regarding mortality and SARS-CoV-2 infection risk, we can conclude that with the appropriate measures taken, it was safe to undergo orthopaedic procedures at our hospital during the first peak of the COVID-19 pandemic in SA.","author":[{"propositions":[],"lastnames":["Waters"],"firstnames":["R"],"suffixes":[]},{"propositions":[],"lastnames":["Dey"],"firstnames":["R"],"suffixes":[]},{"propositions":[],"lastnames":["Laubscher"],"firstnames":["M"],"suffixes":[]},{"propositions":[],"lastnames":["Dunn"],"firstnames":["R"],"suffixes":[]},{"propositions":[],"lastnames":["Maqungo"],"firstnames":["S"],"suffixes":[]},{"propositions":[],"lastnames":["McCollum"],"firstnames":["G"],"suffixes":[]},{"propositions":[],"lastnames":["Nortje"],"firstnames":["M"],"suffixes":[]},{"propositions":[],"lastnames":["Roche"],"firstnames":["S"],"suffixes":[]},{"propositions":[],"lastnames":["Hilton"],"firstnames":["T"],"suffixes":[]},{"propositions":[],"lastnames":["Mugla"],"firstnames":["W"],"suffixes":[]},{"propositions":[],"lastnames":["Held"],"firstnames":["M"],"suffixes":[]}],"doi":"10.7196/SAMJ.2021.V111I8.15766","file":":C$\\$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Waters et al. - 2021 - Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the.pdf:pdf","issn":"2078-5135","journal":"South African Medical Journal","keywords":"19,2,30,30-day mortality,COVID,COVID-19,CoV,Diagnosis,Infection,OA,Orthopaedic,SARS,SARS-CoV-2,Safety,Surgery,Survival,day mortality,fund_not_ack,original","mendeley-tags":"OA,fund_not_ack,original","month":"aug","number":"8","pages":"747–752","pmid":"35227355","title":"Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the first wave of the COVID-19 pandemic: it was safe to perform orthopaedic procedures at our hospital during the first COVID-19 peak","url":"http://www.samj.org.za/index.php/samj/article/view/13361","volume":"111","year":"2021","bibtex":"@article{Waters2021a,\r\nabstract = {Background. Initial local and global evidence suggests that SARS-CoV-2-infected patients who undergo surgery, and those who become infected perioperatively, have an increased mortality risk post surgery. Objectives. To analyse and describe the 30-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection rates of patients, both SARS-CoV-2-positive and negative, undergoing orthopaedic surgery at a tertiary academic hospital in South Africa (SA) during the first COVID-19 peak. Methods. This single-centre, observational, prospective study included patients who underwent orthopaedic procedures from 1 April 2020 (beginning of the COVID-19 case increase in SA) to 31 July 2020 (first COVID-19 peak in SA). All patients were screened for COVID-19 and were confirmed positive if they had a positive laboratory quantitative polymerase chain reaction test for SARS-CoV-2 RNA on a nasopharyngeal or oral swab. Thirty-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection were assessed. Results. Overall, a total of 433 operations were performed on 346 patients during the timeframe. Of these patients, 65.9{\\%} ( n =228) were male and 34.1{\\%} ( n =118) were female. The mean (standard deviation) age was 42.5 (16.8) years (range 9 - 89). Of the patients, 5 (1.4{\\%}) were identified as COVID-19 patients under investigation (PUI) on admission and tested positive for SARS-CoV-2 before surgery, and 1 (0.3{\\%}) contracted SARS-CoV-2 perioperatively; all survived 30 days post surgery. Twenty-nine patients were lost to follow-up, and data were missing for 6 patients. The final analysis was performed excluding these 35 patients. Of the 311 patients included in the final 30-day mortality analysis, 303 (97{\\%}) had a follow-up observation ≥30 days after the operation. The overall 30-day mortality for these patients was 2.5{\\%} ( n =8 deaths). 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