Mortality and pulmonary complications in patients undergoing upper extremity surgery at the peak of the SARS-CoV-2 pandemic in the UK: a national cohort study

1. Mortality and pulmonary complications in patients
undergoing upper extremity surgery at the peak of
the SARS-CoV-2 pandemic in the UK: a national
cohort study
BEN DEAN PRESENTING ON BEHALF OF
THE CORONA HANDS COLLABORATIVE

2. Introduction, Aims and Methods
§Little known about risk of upper limb surgery
§Aim to assess the risk of surgery at the peak of the UK pandemic in Early April 2020
§primary outcome measure was 30-day postoperative mortality
§secondary outcomes were SARS-CoV-2 complication rates and overall complication rates
§Methods
§Retrospective cohort study
§UK wide
§All surgery below the elbow from 1st to 14th April 2020 inclusive
§74 centres

3. Results – Centres and Practice
§74 centres
§72 centres (97%) stopped all elective practice
§Majority (71 centres, 96%) used pre-admission SARS-CoV-2 screening questions
§Majority (54 centres, 73%) were not SARS-CoV-2 testing before surgery
§Practice in terms of face masks, PPE for surgery and positive cases was variable

4. Results – Patients
§Total of 1093 patients, 698 males and 395 females
§Mean age 42
§Majority of surgery urgent or expedited (97%)
§Trauma (88%) and infection (8%) most common indications
§Mixture of local (52%), regional(18%) and general
anaesthesia (30%)

5. Results – Outcomes
§SARS-CoV-2 complication rate 0.18%
§ 2 pneumonias (1 mild and 1 fatal)
§ 30 day mortality 0.09%
§Zero mortality of patients admitted on day of surgery
§Surgical complication rate 6.6% (72 patients)
§Risk factors age/surgery for infection and non-local surgery

6. Conclusions
§SARS-CoV-2 complication rate low in this cohort
§Zero mortality for patients admitted on the day of surgery
§Urgent surgery should not be delayed for SARS-CoV-2 testing
§Implications for service delivery in future SARS-CoV-2 surges and informing patients

7. Thanks to all the team