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2020 ; 44
(8
): 1549-1555
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A clinical pathway for pre-operative screening of COVID-19 and its influence on
clinical outcome in patients with traumatic fractures
#MMPMID32468202
Meng Y
; Leng K
; Shan L
; Guo M
; Zhou J
; Tian Q
; Hai Y
Int Orthop
2020[Aug]; 44
(8
): 1549-1555
PMID32468202
show ga
PURPOSE: Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. The
toughest issue traumatic orthopaedic surgeons are faced with is how to maintain a
balance between adequate COVID-19 screening and timely surgery. In this study, we
described our experience with pre-operative COVID-19 screening in patients with
traumatic fractures. Furthermore, we analysed the clinical results of fracture
patients undergoing confined or emergency surgery during the COVID-19 outbreak.
METHODS: This was a case series study. Patients with traumatic fractures who were
admitted to our hospital for surgery were enrolled in this study during the
COVID-19 outbreak from March to April 2020. All patients were enrolled and
managed using the standardized clinical pathway we designed for preoperative
COVID-19 screening. Clinical, laboratory and outcome data were analysed. RESULTS:
The average surgery waiting time from injury to surgery was 8.7?±?3.4 days. The
average waiting time from admission to surgery was 5.3?±?2.8 days. These average
waiting times were increased by 4.1 days and 2.0 days, respectively, compared
with 2019 data. Cardiovascular complications, venous thromboembolism and
pneumonia occurred in one, two and one patient, respectively. Three and two
patients developed pre-operative and postoperative fevers, respectively.
CONCLUSIONS: We introduced a novel clinical pathway for pre-operatively screening
of COVID-19 in traumatic orthopaedic patients. The delay in surgery caused by
COVID-19 screening was minimized to a point at which reasonable and acceptable
clinical outcomes were achieved. Doctors should pay more attention to
perioperative complications, such as cardiovascular complications, venous
thromboembolism, pneumonia and fever.