Postoperative, But Not Preoperative Coronavirus Disease 2019 (COVID‐19), Is Associated With an Increased Rate of Medical Adverse Events Following Arthroscopic Procedures
Bibliographic record
Abstract
Purpose To characterize how severe acute respiratory syndrome coronavirus 2 infection in the perioperative period affects the medical adverse event (MAE) rates in arthroscopic sports medicine procedures. Methods The Mariner coronavirus disease 2019 (COVID‐19) database was queried for all shoulder, hip, or knee arthroscopies, 2010 to 2020. Patients with COVID‐19 in the 3 months before to 3 months after their surgery were matched by age, sex, and Charlson Comorbidity Index to patients with an arthroscopy but no perioperative COVID‐19 infection, or a COVID‐19 infection but no arthroscopic procedure. MAEs in the 3 months after surgery or illness were compared between groups. Results The final cohort consisted of 1,299 matched patients in 3 groups: COVID‐19 alone, arthroscopy and perioperative COVID‐19, and arthroscopy alone. There were 265 MAEs if a patient had COVID‐19 alone (20.4%), 200 MAEs if a patient had arthroscopy with COVID‐19 (15.4%), and 71 (5.5%) MAEs if a patient had arthroscopy alone ( P < .01). If a patient had an arthroscopy, having COVID‐19 was associated with 3.1‐fold elevated odds (95% confidence interval [CI] 2.9‐3.4, P < .01) of MAE. Among patients with an arthroscopy, MAEs were more common if a patient acquired COVID‐19 in the 3 months after their surgery (pooled odds ratio 7.39, 95% CI 5.49‐9.95, P < .01) but not if a patient had preoperative COVID‐19 (pooled odds ratio 0.66, 95% CI 0.42‐1.03, P = .07). Conclusions Having COVID‐19 during the postoperative period appears to confer a 7‐fold elevated risk of MAEs after shoulder, hip, and knee arthroscopy compared with matched patients with arthroscopy and no perioperative COVID‐19 but equivalent to that of patients with COVID‐19 and no arthroscopy. However, there was no increase in postoperative MAEs if a patient had COVID‐19 during the 3 months preceding surgery. Therefore, it appears safe to conduct an arthroscopic procedure shortly after recovery from COVID‐19 without an increase in acute medical complication rates. Level of evidence Level III, retrospective cohort study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".