Evidence map›Paper›PMID 34144165›Full record

Observational studyWorld neurosurgery2021

Does Coronavirus Disease 2019 (COVID-19) Affect Perioperative Morbidity and Mortality for Patients Requiring Emergency Instrumented Spinal Surgery? A Single-Center Cohort Study.

Mathew Sewell, Fahid Rasul, Kathak Vachhani, Fady Sedra, Syed Aftab, Suresh Pushpananthan, Jonathan Bull, Arun Ranganathan, Alex Montgomery

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in World neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 55% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Mathew SewellDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom. Electronic address: mathew.sewell2@nhs.net.
Fahid RasulDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom.
Kathak VachhaniFaculty of Medicine, University of Toronto, Toronto, Canada.
Fady SedraDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom.
Syed AftabDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom.
Suresh PushpananthanDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom.
Jonathan BullDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom.
Arun RanganathanDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom.
Alex MontgomeryDepartment of Spinal Surgery, Royal London Hospital, London, United Kingdom.
Royal London Hospital · GBUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe coronavirus disease 2019 (COVID-19) pandemic sent shockwaves through health services worldwide. Resources were reallocated. Patients with COVID-19 still required instrumented spinal surgery for emergencies. Clinical outcomes for these patients are not known. The objective of this study was to evaluate the effects of COVID-19 on perioperative morbidity and mortality for patients undergoing emergency instrumented spinal surgery and to determine risk factors for increased morbidity/mortality.

methodsThis retrospective cohort study included 11 patients who were negative for COVID-19 and 8 patients who were positive for COVID-19 who underwent emergency instrumented spinal surgery in 1 hospital in the United Kingdom during the pandemic peak. Data collection was performed through case note review. Patients in both treatment groups were comparable for age, sex, body mass index (BMI), comorbidities, surgical indication, and preoperative neurologic status. Predefined perioperative outcomes were recorded within a 30-day postoperative period. Univariable analysis was used to identify risk factors for increased morbidity.

resultsThere were no mortalities in either treatment group. Four patients positive for COVID-19 (50%) developed a complication compared with 6 (55%) in the COVID-19-negative group (P > 0.05). The commonest complication in both groups was respiratory infection. Three patients positive for COVID-19 (37.5%) required intensive care unit admission, compared with 4 (36%) in the COVID-19-negative group (P > 0.05). The average time between surgery and discharge was 19 and 10 days in COVID-19-positive and -negative groups, respectively (P = 0.02). In the COVID-19 positive group, smoking, abnormal BMI, preoperative oxygen requirement, presence of fever, and oxygen saturations <95% correlated with increased risk of complications.

conclusionsEmergency instrumented spinal surgery in patients positive for COVID-19 was associated with increased length of hospital stay. There was no difference in occurrence of complications or intensive care unit admission. Risk factors for increased morbidity in patients with COVID-19 included smoking, abnormal BMI, preoperative oxygen requirement, fever and saturations <95%.

Indexed as

Spinal FusionAdultAgedCohort StudiesCOVID-19Emergency TreatmentFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRisk FactorsSARS-CoV-2Spinal InjuriesTreatment OutcomeClinical outcomeCohort studyCOVID-19EmergencyInstrumented spine surgery (ISS)Major trauma center (MTC)

Identifiers

PMID34144165
PMCPMC8205544
OpenAlexW3170942656

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.