The impact of COVID-19 on mortality in trauma patients undergoing orthopedic surgery: a systematic review and meta-analysis.

OBJECTIVE: The global spread of the COVID-19 pandemic has affected all aspects, including orthopedic trauma surgery. This study aims to investigate whether COVID-19-positive patients who underwent orthopedic surgery trauma had a higher risk of postoperative mortality.

METHODS: ScienceDirect, the Cochrane COVID-19 Study Register, and MEDLINE were searched for original publications. This study adhered to the PPRISMA 2020 statement. The validity was evaluated using a checklist developed by the Joanna Briggs Institute. Study and participant characteristics, as well as the odds ratio, were extracted from selected publications. Data were analyzed using RevMan ver. 5.4.1.

RESULTS: After applying the inclusion and exclusion criteria, 16 articles among 717 total were deemed eligible for analysis. Lower-extremity injuries were the most common condition, and pelvic surgery was the most frequently performed intervention. There were 456 COVID-19-positive patients (6.12%) and 134 deaths among COVID-19-positive patients, revealing a mortality escalation (29.38% vs. 5.30% among COVID-19-negative patients; odds ratio, 7.72; 95% confidence interval, 6.01-9.93; P<0.00001).

CONCLUSION: Among COVID-19-positive patients, the postoperative death rate increased by 7.72 times. It may be possible to improve prognostic stratification and perioperative care by identifying risk factors.