COVID-19 infection within 30 days after TJA increased risk for mortality, complications
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Key takeaways:
- COVID-19 infection within 30 days after TJA increased risks for mortality, complications and resource utilization.
- Surgeons should counsel patients preoperatively, particularly patients who are unvaccinated.
Published results showed patients who tested positive for COVID-19 within 30 days after total joint arthroplasty had increased risks for mortality, complications, reoperation and non-home discharge compared with those who tested negative.
Alyssa N. Wenzel, MD, and colleagues at the Johns Hopkins University School of Medicine used the National Surgical Quality Improvement Program database to analyze propensity-matched cohorts of 940 patients who underwent total hip arthroplasty and 1,400 patients who underwent total knee arthroplasty in 2021.
Researchers compared outcomes between patients who were COVID-19-positive within 30 days after surgery and patients who were COVID-19-negative. Overall, 135 patients (14.4%) in the THA cohort and 200 patients (14.3%) in the TKA cohort tested positive for COVID-19.
Among the THA cohort, patients who tested positive for COVID-19 had increased risks for pneumonia (odds ratio [OR] = 42.57), sepsis (OR = 12.77), readmission (OR = 12.06), non-home discharge (OR = 3.78) and a longer length of stay (hazard ratio [HR] = 1.62).
Similarly, among the TKA cohort, patients who tested positive for COVID-19 had increased risks for 30-day mortality (OR = 14.17), superficial infection (OR = 3.17), pneumonia (OR = 34.68), unplanned intubation (OR = 18.31), ventilator use (OR = 18.31), pulmonary embolism (OR = 11.98), urinary tract infection (OR = 5.16), myocardial infarction (OR = 16.02), deep vein thrombosis (OR = 4.69), non-home discharge (OR = 1.79), reoperation (OR = 3.17), readmission (OR = 9.61) and a longer length of stay (HR = 1.49).
Wenzel and colleagues also noted the financial burden of increased resource utilization for patients who tested positive for COVID-19.
“Orthopedic surgeons should be aware of these risks as they counsel patients preoperatively, particularly those who are unvaccinated, as their risk of severe infection is increased,” the researchers wrote in the study.
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