ReviewThe bone & joint journal2020
The theoretical mortality risk of an asymptomatic patient with a negative SARS-CoV-2 test developing COVID-19 following elective orthopaedic surgery.
Review in The bone & joint journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- The NICE COVID-19 rapid guideline on haematopoietic stem cell transplantation: development, implementation and impact.British journal of haematology · 2021Guideline
- Early Postoperative Complications in Total Hip and Knee Arthroplasties Before and During the COVID-19 Pandemic: A Retrospective Analysis of 38,234 Patients.Arthroplasty today · 2022Article
- Biomarkers predicting the 30‑day mortality of patients who underwent elective surgery and were infected with SARS‑CoV‑2 during the post‑operative period: A retrospective study.Experimental and therapeutic medicine · 2022Article
- Safe Surgery During the COVID-19 Pandemic.Current obesity reports · 2022Review
- Preoperative Severe Acute Respiratory Syndrome Coronavirus 2 Polymerase Chain Reaction Test at Between 48 and 72 Hours Preoperatively is Safe for Patients Undergoing Primary and Revision Hip and Knee Arthroplasty: A Multicentre International Study.The Journal of arthroplasty · 2022Observational
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- The Impact of Quarantine on Pain Sensation among the General Population in China during the COVID-19 Pandemic.Brain sciences · 2022Article
- The safe resumption of elective orthopaedic services following the first wave of the COVID-19 pandemic : a review of 2,316 consecutive cases and implications for recovery following further waves.Bone & joint open · 2022Article
- Re-starting elective orthopaedic services in NHS Tayside during the COVID-19 pandemic.The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland · 2021Article
- Elective foot and ankle surgery following the peak of the COVID-19 pandemic is safe: A report of 30-day morbidity and mortality.Foot (Edinburgh, Scotland) · 2021Article
- Integrated care systems, research, and innovation.Bone & joint research · 2021Article
- The impact of the COVID-19 pandemic on the length of stay following total hip and knee arthroplasty in a high volume elective orthopaedic unit.Bone & joint open · 2021Article
- Impact of the COVID-19 Outbreak on Orthopedic Surgery: A Nationwide Analysis of the First Pandemic Year.Cureus · 2021Article
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- The orthopaedic waiting list crisis : two sides of the story.Bone & joint open · 2021Article
- Article
- Self-quarantine programme and pre-operative SARS-CoV-2 PCR screening for orthopaedic elective surgery: experience from Japan.International orthopaedics · 2021Article
- Mortality risk of surgically managing orthopaedic trauma during the COVID-19 pandemic.Bone & joint open · 2021Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe risk to patients and healthcare workers of resuming elective orthopaedic surgery following the peak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult to quantify. This has prompted governing bodies to adopt a cautious approach that may be impractical and financially unsustainable. The lack of evidence has made it impossible for surgeons to give patients an informed perspective of the consequences of elective surgery in the presence of SARS-CoV-2. This study aims to determine, for the UK population, the probability of a patient being admitted with an undetected SARS-CoV-2 infection and their resulting risk of death; taking into consideration the current disease prevalence, reverse transcription-polymerase chain reaction (RT-PCR) testing, and preassessment pathway.
methodsThe probability of SARS-CoV-2 infection with a false negative test was calculated using a lower-end RT-PCR sensitivity of 71%, specificity of 95%, and the UK disease prevalence of 0.24% reported in May 2020. Subsequently, a case fatality rate of 20.5% was applied as a worst-case scenario.
resultsThe probability of SARS-CoV-2 infection with a false negative preoperative test was 0.07% (around 1 in 1,400). The risk of a patient with an undetected infection being admitted for surgery and subsequently dying from the coronavirus disease 2019 (COVID-19) is estimated at approximately 1 in 7,000. However, if an estimate of the current global infection fatality rate (1.04%) is applied, the risk of death would be around 1 in 140,000, at most. This calculation does not take into account the risk of nosocomial infection. Conversely, it does not factor in that patients will also be clinically assessed and asked to self-isolate prior to surgery.
conclusionOur estimation suggests that the risk of patients being inadvertently admitted with an undetected SARS-CoV-2 infection for elective orthopaedic surgery is relatively low. Accordingly, the risk of death following elective orthopaedic surgery is low, even when applying the worst-case fatality rate. Cite this article:
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