Dataset Information

Incidence of Symptomatic COVID-19 in Unvaccinated Patients within One Month after Elective Total Joint Arthroplasty: A Multicentre Study.

ABSTRACT:

Background

The safety of continuing Total Joint Arthroplasty (TJA), as an elective procedure, during the pandemic is controversial. The present study aimed to investigate the incidence of symptomatic COVID-19 and its related risk factors in unvaccinated patients after TJA within one month post-discharge in two large cities of our country.

Methods

The present prospective study included all the patients admitted to three hospitals, located in two high-populated cities of our country from April 1st, 2020, to April 1st, 2021, for elective TJA. Urgent TJA (traumatic fractures) were excluded. The primary outcome was symptomatic COVID-19 within one-month after discharge that was diagnosed using the SARS-CoV-2 RT-PCR test. Afterward, the incidence of the COVID-19 in the study population was compared with the general population to estimate the safety of elective TJA during the pandemic.

Results

From the 1007 patients undergoing TJA, 755 patients met the inclusion criteria. None of the patients was vaccinated against COVID-19. Among them, 18 patients (2.4%) developed symptomatic COVID-19 within one-month after discharge. In the same time interval, the incidence of COVID-19 was 2.2% in the general population of these two cities, which was similar to the incidence reported in the study population. Of the patients who were positive for COVID-19, four patients were hospitalized, and 3 of them were ICU-admitted; however, no mortality was reported.

Conclusion

The TJA will be a safe elective procedure for the patients during the pandemic if the preventive protocols are followed strictly.

SUBMITTER: Sheikhbahaei E

PROVIDER: S-EPMC8784429 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundIn an effort to improve quality and reduce costs, reimbursement for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in the United States is being based on the value of care provided, with adjustments for some qualifying comorbidities, including diabetes in its most severe form and excluding many diabetes codes. The aims of this study were to examine the effects of diabetes on elective TKA or THA complications and readmission risks among Medicare beneficiaries.MethodsComplication (n = 521,230) and readmission (n = 515,691) data were extracted from Medicare files in 2013 and 2014. Diabetes status (no diabetes, controlled-uncomplicated diabetes, controlled-complicated diabetes, and uncontrolled diabetes) was identified with ICD-9 (International Classification of Diseases, 9th Revision) codes. TKA or THA complications and readmission odds based on diabetes status were estimated using logistic regression and adjusted for sociodemographic and clinical characteristics, including comorbidities.ResultsCompared with no diabetes, the odds ratio (OR) of TKA complications was significantly higher for uncontrolled diabetes (1.29, 95% confidence interval [CI] = 1.06 to 1.57). The OR of THA complications was significantly higher for controlled-complicated diabetes (1.45, 95% CI = 1.17 to 1.80). The OR of readmission was significantly higher for all diabetes groups (1.21 to 1.48 for TKA, 1.20 to 1.70 for THA).ConclusionsReadmission odds were higher in all diabetes categories. The uncontrolled-diabetes group had the greatest TKA readmission and complication odds. The controlled-complicated diabetes group had the greatest THA readmission and complication odds. The findings suggest that including diabetes and associated systemic complications in cost adjustments in alternative payment models for arthroplasty should be considered.Level of evidencePrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.