BibTex format
@article{Logishetty:2022:10.1302/2633-1462.22.BJO-2020-0200.R1,
author = {Logishetty, K and Edwards, T and Ponniah, HS and Ahmed, M and Liddle, AD and Cobb, J and Clark, C},
doi = {10.1302/2633-1462.22.BJO-2020-0200.R1},
journal = {Bone & Joint Open},
pages = {134--140},
title = {How to prioritise patients and redesign care to safely resume planned surgery during the COVID-19 pandemic. A clinical validation study},
url = {http://dx.doi.org/10.1302/2633-1462.22.BJO-2020-0200.R1},
volume = {2},
year = {2022}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background and Purpose: Restarting planned surgery during the COVID-19 pandemic is a clinical and societal priority, but it is unknown whether it can be done safely and include high-risk or complex cases. We developed a Surgical Prioritization and Allocation Guide (SPAG). Here, we validate its effectiveness and safety in COVID-free sites. Patients and Methods: A multidisciplinary Surgical Prioritisation Committee developed the SPAG, incorporating procedural urgency, shared decision making, patient safety and biopsychosocial factors; and applied it to 1142 adult patients awaiting orthopaedic surgery. Patients were stratified into four priority groups and underwent surgery at three COVID-free sites – including one with access to a High Dependency Unit (HDU) or Intensive Care Unit (ICU) and specialist resources. Safety was assessed by the number of patients requiring inpatient postoperative HDU/ICU admission, contracting COVID-19 within 14 days postoperatively, and mortality within 30 days postoperatively. Results: 1142 patients were included, 47 declined surgery. 110 were deemed high-risk or requiring specialist resources. In the 10-week study period, 28 high-risk patients underwent surgery, during which 68% of Priority 2 (P2, surgery within 1 month) patients underwent surgery, and 15% of P3 (<3 months) and 16% of P4 (>3 months) groups. Of the 1032 low-risk patients, 322 patients underwent surgery. Twenty-one P3 and P4 patients were expedited to ‘Urgent’ based on biopsychosocial factors identified by the SPAG. During the study period, 91% of the Urgent group, 52% of P2, 36% of P3, and 26% of P4 underwent surgery. No patients died or were admitted to HDU/ICU, or contracted COVID-19. Interpretation: Our widely generalisable model enabled the restart of planned surgery during the CO
AU - Logishetty,K
AU - Edwards,T
AU - Ponniah,HS
AU - Ahmed,M
AU - Liddle,AD
AU - Cobb,J
AU - Clark,C
DO - 10.1302/2633-1462.22.BJO-2020-0200.R1
EP - 140
PY - 2022///
SN - 2633-1462
SP - 134
TI - How to prioritise patients and redesign care to safely resume planned surgery during the COVID-19 pandemic. A clinical validation study
T2 - Bone & Joint Open
UR - http://dx.doi.org/10.1302/2633-1462.22.BJO-2020-0200.R1
VL - 2
ER -