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Title: Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?
Authors: Guerado, E.
Cano, J.R.
Pons-Palliser, J.
metadata.dc.contributor.authoraffiliation: [Guerado,E; Cano,JR; Pons-Palliser,J] Hospital Universitario Costa del Sol, University of Malaga, Marbella, Spain.
Keywords: Hip fracture;Infection;Urinary tract infection;Pneumonia;Hip arthroplasty;Infecciones urinarias;Neumonía;Artroplastia de reemplazo de cadera;Fractura de cadera;Systematic review;Revisión sistemática
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Urinary Tract Infections
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Pneumonia, Bacterial
Medical Subject Headings::Organisms::Viruses::RNA Viruses::Mononegavirales::Paramyxoviridae::Pneumovirinae::Pneumovirus
Medical Subject Headings::Diseases::Wounds and Injuries::Fractures, Bone::Hip Fractures
Issue Date: 22-Dec-2020
Publisher: British Editorial Society of Bone and Joint Surgery
Citation: Guerado E, Cano JR, Pons-Palliser J. Should concurrent viral (including COVID-19) or bacterial infections be treated before performing surgery for hip fracture?. Bone & Joint Res. 2020 Dec;9(12):884-893.
Abstract: Aims: A systematic literature review focusing on how long before surgery concurrent viral or bacterial infections (respiratory and urinary infections) should be treated in hip fracture patients, and if there is evidence for delaying this surgery. Methods: A total of 11 databases were examined using the COre, Standard, Ideal (COSI) protocol. Bibliographic searches (no chronological or linguistic restriction) were conducted using, among other methods, the Patient, Intervention, Comparison, Outcome (PICO) template. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for flow diagram and checklist. Final reading of the complete texts was conducted in English, French, and Spanish. Classification of papers was completed within five levels of evidence (LE). Results: There were a total of 621 hits (526 COre; 95 Standard, Ideal) for screening identification, and 107 records were screened. Overall 67 full-text articles were assessed for eligibility, and 21 articles were included for the study question. A total of 46 full-text articles were excluded with reasons. No studies could be included in quantitative synthesis (meta-analyses), and there were many confounding variables including surgeons' experience, prosthesis models used, and surgical technique. Conclusion: Patients with hip fracture and with a viral infection in the upper respiratory tract or without major clinical symptoms should be operated on as soon as possible (LE: I-III). There is no evidence that patients with coronavirus disease 2019 (COVID-19) should be treated differently. In relation to pneumonia, its prevention is a major issue. Antibiotics should be administered if surgery is delayed by > 72 hours or if bacterial infection is present in the lower respiratory tract (LE: III-V). In patients with hip fracture and urinary tract infection (UTI), delaying surgery may provoke further complications (LE: I). However, diabetic or immunocompromised patients may benefit from immediate antibiotic treatment. Cite this article: Bone Joint Res 2020;9(12):884-893.
metadata.dc.identifier.doi: 10.1302/2046-3758.912.BJR-2019-0045.R4
ISSN: 2046-3758 (Online)
Appears in Collections:01- Artículos - APES Costa del Sol

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