Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2021; 12(10): 751-759
Published online Oct 18, 2021. doi: 10.5312/wjo.v12.i10.751
SARS-CoV-2 outbreak impact on a trauma unit
Sarah Mills, Aitor Ibarzábal-Gil, José M Martínez-Diez, Javier Pallarés-Sanmartín, Carlos Kalbakdij-Sánchez, Juan C Rubio-Suárez, Itsaso Losantos-García, E Carlos Rodríguez-Merchán
Sarah Mills, Aitor Ibarzábal-Gil, José M Martínez-Diez, Javier Pallarés-Sanmartín, Carlos Kalbakdij-Sánchez, Juan C Rubio-Suárez, E Carlos Rodríguez-Merchán, Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain
Itsaso Losantos-García, Department of Biostatistics, La Paz University Hospital, Madrid 28046, Spain
E Carlos Rodríguez-Merchán, Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
Author contributions: Mills S was the author primarily responsible for the writing of the text; Rubio-Suárez JC and Rodríguez-Merchán EC assisted in the writing and editing of the text; the other authors provided critical expertise and input into the subject matter of the text.
Institutional review board statement: The study was approved by our Hospital’s Ethics Committee (La Paz University Hospital, Madrid, Spain).
Informed consent statement: All patients of this study signed an “informed consent” before surgery.
Conflict-of-interest statement: The authors have nothing to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: E Carlos Rodríguez-Merchán, MD, PhD, Doctor, Department of Orthopedic Surgery, La Paz University Hospital, Paseo de la Castellana, 261, Spain. ecrmerchan@hotmail.com
Received: March 24, 2021
Peer-review started: March 24, 2021
First decision: June 16, 2021
Revised: June 17, 2021
Accepted: August 18, 2021
Article in press: August 18, 2021
Published online: October 18, 2021
Processing time: 203 Days and 16.6 Hours
ARTICLE HIGHLIGHTS
Research background

From February 2020 onwards our country has been hit by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. At a glance, hospitals became overrun and had to reformulate all the assistance guidelines, focusing on the coronavirus disease 2019.

Research motivation

One year after the start of the pandemic, we present the results of a morbimortality study.

Research objectives

The main objective of this study is to analyze how our department was affected by the outbreak, in terms of morbimortality. As secondary objectives, we analyzed demographic data, admission to hospital-related data, and subgroups analyses for patients with hip fractures and polytrauma.

Research methods

We designed a study based on two sections in our tertiary hospital. The first is a cohort prospective study based on data collected on patients admitted to our unit during the pandemic (from March to April 2020, due to a lower limb fracture or a high energy trauma during the pandemic situation). This cohort completed a minimum of 6 mo of follow-up. The second part consists of the study of another cohort of patients, with the same inclusion criteria but selected in 2019, the only difference between them being the presence of SARS-CoV-2 in 2020 and its implications.

Research results

The number of patients admitted to hospital in 2020 was nearly half of those in 2019. Hip fractures in the elderly represented the vast majority of fractures during the outbreak. The incidence of polytrauma did not vary substantively, although the mechanism of injury did. Patients with a hip fracture associated with a severe respiratory syndrome were mostly selected for conservative treatment. Mortality and readmission rates were higher in the 2020 cohort and during follow-up in comparison with the cohort in 2019. Patients with SARS-CoV-2 infection were admitted to the hospital for a longer time than the non-infected, and also had a higher mortality rate during hospitalization and follow-up.

Research conclusions

The SARS-CoV-2 disease is not a criterion for not performing surgery. Mortality and readmission rates were higher in the 2020 cohort and during follow-up, in comparison with the cohort in 2019. Hip fractures in the elderly represented the vast majority of fractures during the outbreak. The incidence of polytrauma did not vary substantively although the mechanism of injury did.

Research perspectives

The SARS-CoV-2 disease is not a criterion for not performing surgery.