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The Relationship of Orthopaedic Elective Surgical Procedures and The Incidence Rate of COVID-19 during the Pandemic Period at the Cipto Mangunkusumo National Central General Hospital

Project Overview

Background: To date, there is no recommendations have been published on when and how to start again carrying out elective, non-urgent surgery on COVID-19-negative patients after the epidemic peak has been reached in a given country or region and the pressure on healthcare facilities, healthcare workers and resources has been released by so far that elective surgery procedures can be safely and ethically programmed again. This study aims to investigate whether elective orthopaedic surgery will increase the risk of developing COVID-19. Materials and Methods: This was a combined retrospective and prospective studies performed at a national tertiary hospital in Jakarta, Indonesia. Subjects were patients who underwent elective orthopaedic surgeries at our institution from April to May 2020. Those who were previously infected with COVID-19 from polymerase chain reaction (PCR) reverse transcriptase (RT) examination obtained via nasopharynx and oropharynx swab, as well as those who were reluctant to participate were excluded from the study. Results: A total of 35 subjects (mean age 32.89 ± 17.42) were recruited for. Total sampling was performed for the participants from April 1st to May 26th 2020. Fifteen (42.9%) subjects were male, and 20 subjects (57.1%) were female. Mean duration of surgery was 240 minutes with the longest and shortest duration of 690 and 40 minutes, respectively. General anaesthesia was performed in the majority of cases in 18 surgeries (51.4%) with local anaesthesia as the least in 2 surgeries (5.7%). Length of stay of our study was 6 days of average. None of the patients developed symptoms suggestive of COVID-19 infection. Conclusion: We found that elective orthopaedic surgery was not associated with increased cases of COVID-19 cases. Factors including duration of surgery, length of stay, types of anaesthesia and comorbidities were also not associated with COVID-19 cases in this study.

Study Design

combined retrospective and prospective studies

Project Keywords

Orthopedic, elective surgery, COVID-19, risk, incidence rate

Principal Investigator

Name: Achmad Fauzi
Kamal

Title: Professor

Department or Unit: Department of Orthopaedics and Traumatology

Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Co-Project Investigators

  • Name: Wahyu
    Widodo
    Title: MD
    Department or Unit: Department of Orthopaedics and Traumatology
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Mohamad Walid
    Kuncoro
    Title: MD
    Department or Unit: Department of Orthopaedics and Traumatology
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Yogi
    Prabowo
    Title: MD
    Department or Unit: Department of Orthopaedics and Traumatology
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Gurmeet
    Sigh
    Title: MD
    Department or Unit: Department of Internal Medicine
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Lies Dina
    Liastuti
    Title: MD
    Department or Unit: Cipto Mangunkusumo Hospital, Jakarta, Indonesia
    Organization: Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Trimartani
    Trimartani
    Title: MD
    Department or Unit: Departement of Ear, Nose, and Throat
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Errol Untung
    Hutagalung
    Title: Prof
    Department or Unit: Department of Orthopaedics and Traumatology
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Ifran
    Saleh
    Title: MD
    Department or Unit: Department of Orthopaedics and Traumatology
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: S. Dohar Apul Lumban
    Tobing
    Title: MD
    Department or Unit: Department of Orthopaedics and Traumatology
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Name: Bambang
    Gunawan
    Title: MD
    Department or Unit: Department of Orthopaedics and Traumatology
    Organization: Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Funding Source

N/A

Expected Study Timeline

April 1, 2020 to May 26, 2020

Study Design

combined retrospective and prospective studies

Primary Methods of Data Collection

examined preoperatively by laboratory testing (routine blood test and differential blood count) and plain chest radiograph. The patients also underwent COVID-19 screening by SARS CoV-2 Immunoglobulin G & IgM antibody test using 2019-nCoV IgG/IgM Detection Kit® (Vazyme Biotech, China).

Unit of Analysis

Individuals

Study Population(s)

Subjects were patients who underwent elective orthopaedic surgeries at our institution from April to May 2020

Sample Size

35

Geographic Focus Area(s)

a national tertiary hospital in Jakarta, Indonesia

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