COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery

Ankle fractures have continued to occur through the COVID pandemic and, regardless of patient COVID status, often need operative intervention for optimizing long-term outcomes. For healthcare optimization, patient counseling, and care planning, understanding if COVID-positive patients undergoing ank...

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Published in:PloS one 2021-12, Vol.16 (12), p.e0262115-e0262115
Main Authors: Mercier, Michael R, Galivanche, Anoop R, Brand, Jordan P, Pathak, Neil, Medvecky, Michael J, Varthi, Arya G, Rubin, Lee E, Grauer, Jonathan N
Format: Article
Language:English
Subjects:
Adolescent
Adult
Ankle
Ankle Fractures - epidemiology
Biology and Life Sciences
Cardiovascular disease
Child
Child, Preschool
Codes
Comorbidity
Complications
Complications and side effects
Coronaviruses
COVID-19
COVID-19 - epidemiology
Data collection
Databases, Factual
Demographics
Demography
Diabetes
Diabetes mellitus
Female
Fractures
Health risks
Humans
Hypertension
Infant
Infant, Newborn
Injuries
Internal fixation in fractures
Kidney diseases
Male
Matching
Medical research
Medicine
Medicine and Health Sciences
Middle Aged
Multivariate analysis
Obesity
Open Fracture Reduction - adverse effects
Optimization
Orthopedics
Pandemics
Patient outcomes
Patients
Postoperative
Postoperative Complications - epidemiology
Rehabilitation
Research and Analysis Methods
Retrospective Studies
Risk analysis
Risk Factors
Severe acute respiratory syndrome coronavirus 2
Surgery
Surgical outcomes
United States - epidemiology
Young Adult
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container_end_page e0262115
container_issue 12
container_start_page e0262115
container_title PloS one
container_volume 16
creator Mercier, Michael R
Galivanche, Anoop R
Brand, Jordan P
Pathak, Neil
Medvecky, Michael J
Varthi, Arya G
Rubin, Lee E
Grauer, Jonathan N
description Ankle fractures have continued to occur through the COVID pandemic and, regardless of patient COVID status, often need operative intervention for optimizing long-term outcomes. For healthcare optimization, patient counseling, and care planning, understanding if COVID-positive patients undergoing ankle fracture surgery are at increased risk for perioperative adverse outcomes is of interest. The COVID-19 Research Database contains recent United States aggregated insurance claims. Patients who underwent ankle fracture surgery from April 1st, 2020 to June 15th, 2020 were identified. COVID status was identified by ICD coding. Demographics, comorbidities, and postoperative complications were extracted based on administrative data. COVID-positive versus negative patients were compared with univariate analyses. Propensity-score matching was done on the basis of age, sex, and comorbidities. Multivariate regression was then performed to identify risk factors independently associated with the occurrence of 30-day postoperative adverse events. In total, 9,835 patients undergoing ankle fracture surgery were identified, of which 57 (0.58%) were COVID-positive. COVID-positive ankle fracture patients demonstrated a higher prevalence of comorbidities, including: chronic kidney disease, diabetes, hypertension, and obesity (p
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For healthcare optimization, patient counseling, and care planning, understanding if COVID-positive patients undergoing ankle fracture surgery are at increased risk for perioperative adverse outcomes is of interest. The COVID-19 Research Database contains recent United States aggregated insurance claims. Patients who underwent ankle fracture surgery from April 1st, 2020 to June 15th, 2020 were identified. COVID status was identified by ICD coding. Demographics, comorbidities, and postoperative complications were extracted based on administrative data. COVID-positive versus negative patients were compared with univariate analyses. Propensity-score matching was done on the basis of age, sex, and comorbidities. Multivariate regression was then performed to identify risk factors independently associated with the occurrence of 30-day postoperative adverse events. In total, 9,835 patients undergoing ankle fracture surgery were identified, of which 57 (0.58%) were COVID-positive. 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For healthcare optimization, patient counseling, and care planning, understanding if COVID-positive patients undergoing ankle fracture surgery are at increased risk for perioperative adverse outcomes is of interest. The COVID-19 Research Database contains recent United States aggregated insurance claims. Patients who underwent ankle fracture surgery from April 1st, 2020 to June 15th, 2020 were identified. COVID status was identified by ICD coding. Demographics, comorbidities, and postoperative complications were extracted based on administrative data. COVID-positive versus negative patients were compared with univariate analyses. Propensity-score matching was done on the basis of age, sex, and comorbidities. Multivariate regression was then performed to identify risk factors independently associated with the occurrence of 30-day postoperative adverse events. In total, 9,835 patients undergoing ankle fracture surgery were identified, of which 57 (0.58%) were COVID-positive. COVID-positive ankle fracture patients demonstrated a higher prevalence of comorbidities, including: chronic kidney disease, diabetes, hypertension, and obesity (p&lt;0.05 for each). After propensity matching and controlling for all preoperative variables, multivariate analysis found that COVID-positive patients were at increased risk of any adverse event (odds ratio [OR] = 3.89, p = 0.002), a serious adverse event (OR = 5.48, p = 0.002), and a minor adverse event (OR = 3.10, p = 0.021). COVID-positive patients will continue to present with ankle fractures requiring operative intervention. Even after propensity matching and controlling for patient factors, COVID-positive patients were found to be at increased risk of 30-day perioperative adverse events. Not only do treatment teams need to be protected from the transmission of COVID in such situations, but the increased incidence of perioperative adverse events needs to be considered.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34972190</pmid><doi>10.1371/journal.pone.0262115</doi><tpages>e0262115</tpages><orcidid>https://orcid.org/0000-0002-2626-7278</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
ispartof PloS one, 2021-12, Vol.16 (12), p.e0262115-e0262115
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_2615612783
source Open Access: PubMed Central; Publicly Available Content Database (Proquest) (PQ_SDU_P3)
subjects Adolescent
Adult
Ankle
Ankle Fractures - epidemiology
Biology and Life Sciences
Cardiovascular disease
Child
Child, Preschool
Codes
Comorbidity
Complications
Complications and side effects
Coronaviruses
COVID-19
COVID-19 - epidemiology
Data collection
Databases, Factual
Demographics
Demography
Diabetes
Diabetes mellitus
Female
Fractures
Health risks
Humans
Hypertension
Infant
Infant, Newborn
Injuries
Internal fixation in fractures
Kidney diseases
Male
Matching
Medical research
Medicine
Medicine and Health Sciences
Middle Aged
Multivariate analysis
Obesity
Open Fracture Reduction - adverse effects
Optimization
Orthopedics
Pandemics
Patient outcomes
Patients
Postoperative
Postoperative Complications - epidemiology
Rehabilitation
Research and Analysis Methods
Retrospective Studies
Risk analysis
Risk Factors
Severe acute respiratory syndrome coronavirus 2
Surgery
Surgical outcomes
United States - epidemiology
Young Adult
title COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery
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