Outcomes of orthopaedic trauma surgery in COVID-19 positive patients.

Autor:	Al-Humadi SM; Department of Orthopaedic Surgery, SUNY Stony Brook University Hospital., Tantone R; Department of Orthopaedic Surgery, SUNY Stony Brook University Hospital., Nazemi AK; Department of Orthopaedic Surgery, SUNY Stony Brook University Hospital., Hays T; Renaissance School of Medicine at Stony Brook University, Stony Brook, New York., Pawlak A; Department of Orthopaedic Surgery, SUNY Stony Brook University Hospital., Komatsu DE; Department of Orthopaedic Surgery, SUNY Stony Brook University Hospital., Namm JD; Department of Orthopaedic Surgery, SUNY Stony Brook University Hospital.
Jazyk:	angličtina
Zdroj:	OTA international : the open access journal of orthopaedic trauma [OTA Int] 2021 May 18; Vol. 4 (2), pp. e129. Date of Electronic Publication: 2021 May 18 (Print Publication: 2021).
DOI:	10.1097/OI9.0000000000000129
Abstrakt:	Objectives: To investigate outcomes for operative orthopaedic trauma in patients who tested positive for coronavirus disease 2019 (COVID-19) during the height of the COVID-19 pandemic in New York. Design: Retrospective case series. Setting: Urban Level-1 academic trauma center. Patients/participants: Thirteen patients diagnosed with COVID-19 who underwent surgical management for orthopaedic trauma between January 21, 2020 and May 11, 2020. Intervention: Does not apply to this study. Main Outcome Measurements: Complications including death, coma lasting more than 24 hours, prolonged mechanical ventilation, unplanned intubation, blood transfusion, postoperative pneumonia, cerebrovascular event, thromboembolic event, myocardial infarction, urinary tract infection, acute renal failure, septic shock, return to the operating room, wound dehiscence, surgical site infection, graft/prosthesis/flap failure, and peripheral nerve injury. Results: Two (18%) patients had symptoms of COVID-19 (cough, shortness of breath, fevers, chills, nausea/vomiting, diarrhea, abdominal cramps/pains) on admission. Average length of stay (standard deviation) was 6.6 (4.31) days. Average time to follow up was 29 (10.77) days. Three (27%) patients developed pneumonia postoperatively and 1 (9%) underwent unplanned intubation. One (9%) patient was intubated for greater than 48 hours. Two (18%) patients developed postoperative deep venous thromboembolism. Three (27%) patients developed acute renal failure postoperatively. Six (55%) patients underwent blood transfusion intraoperatively or postoperatively. Two (18%) patients died postoperatively. Conclusion: In this small series surgical management in Coronavirus-19 positive patients with skeletal injuries was successfully accomplished with patient anticoagulation, hematologic, and pulmonary status in mind. Therapeutic anticoagulation and patient hematologic status were optimized prior to the operating room to minimize development of venous thromboembolism and avoid blood transfusion. Level of Evidence: Level IV prognostic. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.)
Databáze:	MEDLINE
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