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Impact of Postoperative COVID-19 Infection Status on Outcomes in Elective Primary Total Joint Arthroplasty

Alyssa N Wenzel1, Majd Marrache1, Jessica Schmerler1

  • 1Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

The Journal of Arthroplasty
|October 18, 2023
PubMed

Insights

Postoperative COVID-19 infection significantly increases risks for patients undergoing total joint arthroplasty (TJA), leading to higher rates of mortality, complications, and readmissions. Understanding these risks is crucial for orthopedic surgeons and patient counseling.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) poses significant morbidity and mortality risks.
  • The impact of postoperative COVID-19 infection on total joint arthroplasty (TJA) outcomes remains unclear.

Purpose of the Study:

  • To evaluate the 30-day outcomes for patients who contract COVID-19 after undergoing TJA.
  • To compare outcomes between COVID-19-positive and COVID-19-negative patients following TJA.

Main Methods:

  • Utilized the National Surgical Quality Improvement Program database for 2,340 TJA patients in 2021.
  • Implemented propensity score matching to compare outcomes for postoperative COVID-19-positive and negative patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Main Results:

  • Postoperative COVID-19-positive THA patients showed increased risks of pneumonia, sepsis, readmission, and longer hospital stays.
  • Postoperative COVID-19-positive TKA patients faced higher risks of 30-day mortality, infections, pulmonary embolism, myocardial infarction, reoperation, and extended hospital stays.

Conclusions:

  • Patients contracting COVID-19 within 30 days after TJA experience elevated risks of mortality, medical complications, readmissions, reoperations, and non-home discharges.
  • Orthopedic surgeons must counsel patients on these adverse outcomes and implement risk mitigation strategies, especially for high-risk populations.
Abstract

Keywords:
NSQIParthroplastycoronavirusoutcomespropensity score matching

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