Foot and ankle surgery patients had significant mortality rate with COVID-19 diagnosis
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Although uncommon among patients who underwent foot and ankle surgery, patients who contracted COVID-19 had a significant mortality rate, according to results presented at the Virtual EFORT Congress.
Karan Malhotra, MBChB (Hons), MRCS, FRCS (Tr & Ortho), and colleagues in the U.K. Foot and Ankle COVID-19 National Audit Collaborative collected demographics, surgical data, comorbidity data, COVID-19 and mortality rates, complications and infection rates among 6,644 patients who underwent foot and ankle surgery between Jan. 13 and July 31, 2020, at 43 centers across the United Kingdom.
“We, therefore, examined time periods immediately before, during and immediately after the first unique U.K. national lockdown,” Malhotra said in his presentation.
Malhotra noted 0.52% of patients undergoing foot and ankle surgery contracted COVID-19, which included patients who contracted COVID-19 in the 7 days before or up to 30 days following surgery.
“We saw the most number of COVID-19 cases in patients undergoing surgery for trauma, but the highest rate of infection was in patients undergoing surgery for decompensated diabetic foot and ankle disease,” Malhotra said. “If we examine just our elective cohort, we saw that no patients in the elective group contracted COVID-19 during the lockdown period or after the lockdown period.”
Results showed an overall all cause 30-day mortality rate of 0.41%. However, Malhotra noted they found a higher, statistically significant mortality rate of 25.7% in patients who contracted COVID-19. Propensity matching and regression analysis showed a positive diagnosis of COVID-19 was the strongest independent risk factor for mortality, according to Malhotra.
“Patients and treating clinicians should be aware of the risks to enable informed decisions to take place and ensure procedures are in place to reduce the risk to patients,” Malhotra said.
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Houchen-Wollof L, et al. Paper 1373. Presented at: Virtual EFORT Congress; June 30-July 2, 2021.
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