Outcomes of SARS-CoV-2 infection among patients with orthopaedic fracture surgery in the National COVID Cohort Collaborative (N3C).

Autor: Levitt EB; Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA; Department of Translational Medicine, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA., Patch DA; Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA., Hess MC; Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA., Terrero A; Department of Translational Medicine, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA; Department of Translational Medicine, School of Medicine, University of Miami Miller, Miami, FL, USA., Jaeger B; Department of Epidemiology, University of Alabama, Birmingham, AL, USA., Haendel MA; Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Chute CG; Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, MD, USA., Yeager MT; Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA., Ponce BA; Hughston Clinic, Columbus, GA, USA., Theiss SM; Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA., Spitler CA; Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA., Johnson JP; Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA. Electronic address: joey.johnson12@gmail.com.
Jazyk: angličtina
Zdroj: Injury [Injury] 2023 Dec; Vol. 54 (12), pp. 111092. Date of Electronic Publication: 2023 Oct 12.
DOI: 10.1016/j.injury.2023.111092
Abstrakt: Background: The objective of this study was to investigate the outcomes of COVID-19-positive patients undergoing orthopaedic fracture surgery using data from a national database of U.S. adults with a COVID-19 test for SARS-CoV-2.
Methods: This is a retrospective cohort study using data from a national database to compare orthopaedic fracture surgery outcomes between COVID-19-positive and COVID-19-negative patients in the United States. Participants aged 18-99 with orthopaedic fracture surgery between March and December 2020 were included. The main exposure was COVID-19 status. Outcomes included perioperative complications, 30-day all-cause mortality, and overall all-cause mortality. Multivariable adjusted models were fitted to determine the association of COVID-positivity with all-cause mortality.
Results: The total population of 6.5 million patient records was queried, identifying 76,697 participants with a fracture. There were 7,628 participants in the National COVID Cohort who had a fracture and operative management. The Charlson Comorbidity Index was higher in the COVID-19-positive group (n = 476, 6.2 %) than the COVID-19-negative group (n = 7,152, 93.8 %) (2.2 vs 1.4, p<0.001). The COVID-19-positive group had higher mortality (13.2 % vs 5.2 %, p<0.001) than the COVID-19-negative group with higher odds of death in the fully adjusted model (Odds Ratio=1.59; 95 % Confidence Interval: 1.16-2.18).
Conclusion: COVID-19-positive participants with a fracture requiring surgery had higher mortality and perioperative complications than COVID-19-negative patients in this national cohort of U.S. adults tested for COVID-19. The risks associated with COVID-19 can guide potential treatment options and counseling of patients and their families. Future studies can be conducted as data accumulates.
Level of Evidence: Level III.
Competing Interests: Declaration of Competing Interest The analyses described in this report were conducted with data or tools accessed through the NCATS N3C Data Enclave https://covid.cd2h.org and N3C Attribution & Publication Policy v 1.2-2020-08-25b supported by NCATS U24 TR002306 and NCATS UL1 TR003096. This research was possible because of the patients whose information is included within the data and the organizations (https://ncats.nih.gov/n3c/resources/data-contribution/data-transfer-agreement-signatories) and scientists who have contributed to the on-going development of this community resource [https://doi.org/10.1093/jamia/ocaa196/5893482].
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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