Mortality of high‐risk orthopaedic oncology patients during the COVID‐19 pandemic: A prospective cohort study

Stevenson, Jonathan D.; Evans, Scott; Morris, Guy; Tillman, Roger; Abudu, Adesegun; Jeys, Lee; Parry, Michael

BACKGROUND AND OBJECTIVES: Should the threshold for orthopaedic oncology surgery during the coronavirus disease‐2019 (COVID‐19) pandemic be higher, particularly in men aged 70 years and older? This study reports the incidence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) during, respiratory complications and 30‐day mortality during the COVID‐19 pandemic. METHODS: This prospective observational cohort study included 100 consecutive patients. The primary outcome measure was 14‐day symptoms and/or SARS‐CoV‐2 test. The secondary outcome was 30‐day postoperative mortality. RESULTS: A total of 100 patients comprising 35 females and 65 males, with a mean age of 52.4 years (range, 16‐94 years) included 16 males aged greater than 70 years. The 51% of patients were tested during their admission for SARS‐CoV‐2; 5% were diagnosed/developed symptoms of SARS‐CoV‐2 during and until 14 days post‐discharge; four were male and one female, mean age 41.2 years (range, 17‐75 years), all had primary malignant bone or soft‐tissue tumours, four of five had received immunosuppressive therapy pre‐operatively. The 30‐day mortality was 1% overall and 20% in those with SARS‐CoV‐2. The pulmonary complication rate was 3% overall. CONCLUSIONS: With appropriate peri‐operative measures to prevent viral transmission, major surgery for urgent orthopaedic oncology patients can continue during the COVID‐19 pandemic. These results need validating with national data to confirm these conclusions.