Systematic Review : Pengaruh Infeksi COVID-19 terhadap Kejadian Tromboemboli dalam Kasus Operasi Ortopedi
DOI:
https://doi.org/10.31282/joti.v4n2.74Kata Kunci:
COVID-19, SARS-CoV-2, Tromboemboli, Operasi ortopedi, KomplikasiAbstrak
Pendahuluan: COVID-19 mulai dianggap sebagai penyakit inflamasi dengan peningkatan faktor prokoagulan. Operasi ortopedi juga memiliki kejadian tromboemboli yang tinggi. Systematic review ini bertujuan untuk memberikan penjelasan dan pertimbangan bagi dokter ortopedi dalam menangani kasus operasi ortopedi dengan COVID-19 dalam hal kemungkinan peningkatan kejadian fenomena tromboemboli.
Metode: Pencarian literatur dilakukan pada Pubmed, Cochrane central database, MedRvix, dan PubMed Central sampai 10 November 2020 dengan kata kunci pencarian: ( COVID-19 OR SARS-CoV-2) AND (hip fracture OR femoral fracture OR TKA OR THA)
Hasil: Kombinasi trauma jaringan lunak, keterbatasan mobilitas, dan kondisi prokoagulan pada COVID-19 dapat membebani cadangan biologis pasien dan menyebakan disfungsi endotel. Disfungsi endotel dapat menyebabkan pengendapatn fibrin dan pembentukan trombus. Temuan ini tercermin dalam peningkatan D-dimer dan CRP pada pasien COVID-19. Kelompok pasien ini ditemukan mengalami penundaan dari waktu fraktur hingga masuk RS. Mereka cenderung mengobservasi kondisi di rumah dahulu karena menghindari aktivitas di luar rumah atau RS. Penundaan juga terjadi dari waktu masuk RS hingga operasi karena proses skrining COVID-19 atau kondisi pasien tidak memungkinkan untuk operasi. Setiap penundaan dapat meningkatkan kejadian tromboemboli akibat imobilisasi lebih panjang. Untuk mengurangi tromboemboli pada kelompok pasien ini, beberapa RS telah menerapkan jalur pelayanan modifikasi untuk kasus trauma, pemberian profilaksis trombus perioperatif, dan menghindari prosedur dan waktu bedah dengan resiko tromboemboli tinggi.
Kesimpulan: Dari data yang terbatas, infeksi COVID-19 cenderung dapat meningkatkan kejadian tromboemboli pada pasien bedah ortopedi. Dalam menghadapi pasien bedah ortopedi dengan COVID-19, pengambilan keputusan tatalaksana harus dilakukan secara individu dengan menilai manfaat / resiko dan peluang terjadinya tromboemboli.
Referensi
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020 Mar 26;382(13):1199–207.
Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: What we know. Int J Infect Dis. 2020 May;94:44–8.
Liu PP, Blet A, Smyth D, Li H. The Science Underlying COVID-19: Implications for the Cardiovascular System. Circulation. 2020 Jul 7;142(1):68–78.
Mi B, Chen L, Xiong Y, Xue H, Zhou W, Liu G. Characteristics and early prognosis of covid-19 infection in fracture patients. J Bone Jt Surg - Am Vol. 2020;102(9):750–8.
Anderson FA, Spencer FA. Risk factors for venous thromboembolism. Circulation. 2003 Jun 17;107(23 Suppl 1):I9-16.
Flevas DA, Megaloikonomos PD, Dimopoulos L, Mitsiokapa E, Koulouvaris P, Mavrogenis AF. Thromboembolism prophylaxis in orthopaedics: an update. EFORT Open Rev. 2018 Apr 27;3(4):136–48.
Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, et al. Prevention of Venous Thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004 Sep 1;126(3, Supplement):338S-400S.
White RH. The epidemiology of venous thromboembolism. Circulation. 2003 Jun 17;107(23 Suppl 1):I4-8.
Kayani B, Onochie E, Patil V, Begum F, Cuthbert R, Ferguson D, et al. The effects of COVID-19 on perioperative morbidity and mortality in patients with hip fractures. Bone Jt J. 2020 Sep;102-B(9):1279–80.
Egol KA, Konda SR, Bird ML, Dedhia N, Landes EK, Ranson RA, et al. Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective. J Orthop Trauma [Internet]. 2020 May 27 [cited 2020 Oct 27]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302075/
Egol KA, Konda SR, Bird ML, Dedhia N, Landes EK, Ranson RA, et al. Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective. J Orthop Trauma. 2020 Aug;34(8):395–402.
Fuji T, Akagi M, Abe Y, Oda E, Matsubayashi D, Ota K, et al. Incidence of venous thromboembolism and bleeding events in patients with lower extremity orthopedic surgery: a retrospective analysis of a Japanese healthcare database. J Orthop Surg [Internet]. 2017 Apr 4 [cited 2021 Jan 24];12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381070/
Chu C-C, Haga H. Venous thromboembolism associated with lower limb fractures after trauma: dilemma and management. J Orthop Sci. 2015 Jan 1;20(2):364–72.
Lasanianos NG, Kanakaris NK, Giannoudis PV. Intramedullary Nailing as a ‘Second Hit’ Phenomenon in Experimental Research: Lessons Learned and Future Directions. Clin Orthop. 2010 Sep;468(9):2514–29.
Roberts CS, Pape H-C, Jones AL, Malkani AL, Rodriguez JL, Giannoudis PV. Damage control orthopaedics: evolving concepts in the treatment of patients who have sustained orthopaedic trauma. Instr Course Lect. 2005;54:447–62.
Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Jun 16;75(23):2950–73.
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet Lond Engl. 2020;395(10229):1033–4.
Liu B, Li M, Zhou Z, Guan X, Xiang Y. Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)? J Autoimmun. 2020 Jul 1;111:102452.
Lillicrap D. Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia. J Thromb Haemost JTH. 2020 Apr;18(4):786–7.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet Lond Engl. 2020 Mar 28;395(10229):1054–62.
Puzzitiello RN, Pagani NR, Moverman MA, Moon AS, Menendez ME, Ryan SP. Inflammatory and Coagulative Considerations for the Management of Orthopaedic Trauma Patients With COVID-19: A Review of the Current Evidence and Our Surgical Experience. J Orthop Trauma. 2020 Aug;34(8):389–94.
Cheung ZB, Forsh DA. Early outcomes after hip fracture surgery in COVID-19 patients in New York City. J Orthop. 2020;21:291–6.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet Lond Engl. 2020 Feb 15;395(10223):497–506.
Tu Y-K, On Tong G, Wu C-H, Sananpanich K, Kakinoki R. Soft-tissue injury in orthopaedic trauma. Injury. 2008 Oct;39 Suppl 4:3–17.
Pape H-C, Giannoudis P, Krettek C. The timing of fracture treatment in polytrauma patients: relevance of damage control orthopedic surgery. Am J Surg. 2002 Jun;183(6):622–9.
Meng Y, Leng K, Shan L, Guo M, Zhou J, Tian Q, et al. A clinical pathway for pre-operative screening of COVID-19 and its influence on clinical outcome in patients with traumatic fractures. Int Orthop. 2020 Aug;44(8):1549–55.
Minet C, Potton L, Bonadona A, Hamidfar-Roy R, Somohano CA, Lugosi M, et al. Venous thromboembolism in the ICU: main characteristics, diagnosis and thromboprophylaxis. Crit Care. 2015 Aug 18;19(1):287.
Horner D, Pandor A, Goodacre S, Clowes M, Hunt BJ. Individual risk factors predictive of venous thromboembolism in patients with temporary lower limb immobilization due to injury: a systematic review. J Thromb Haemost JTH. 2019 Feb;17(2):329–44.
Kaidi AC, Held MB, Boddapati V, Trofa DP, Neuwirth AL. Timing and Tips for Total Hip Arthroplasty in a Critically Ill Patient With Coronavirus Disease 2019 and a Femoral Neck Fracture. Arthroplasty today Elsevier Inc; Sep, 2020 p. 570.
A D, F S-G, Le G, M P, A O, T V. Impact of time to surgery in upper femoral fracture in orthogeriatrics. Orthop Traumatol Surg Res OTSR. 2019 Jul 10;105(5):975–8.
Nopp S, Moik F, Jilma B, Pabinger I, Ay C. Risk of venous thromboembolism in patients with COVID-19: A systematic review and meta-analysis. Res Pract Thromb Haemost. 2020 Sep 25;
Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020 Apr;21:100331.
Overstad S, Tjonnfjord E, Garabet L, Fronas S, Bergan J, Aballi S, et al. Venous thromboembolism and coronavirus disease 2019 in an ambulatory care setting - A report of 4 cases. Thromb Res. 2020 Oct;194:116–8.
Lim MA, Pranata R. Coronavirus disease 2019 (COVID-19) markedly increased mortality in patients with hip fracture - A systematic review and meta-analysis. J Clin Orthop Trauma. 2020 Sep;
British Committee for Standards in Haematology Writing Group, Baglin TP, Brush J, Streiff M. Guidelines on use of vena cava filters. Br J Haematol. 2006 Sep;134(6):590–5.
Abdelnasser MK, Morsy M, Osman AE, Abdelkawi AF, Ibrahim MF, Eisa A, et al. COVID-19. An update for orthopedic surgeons. SICOT-J. 2020;6.
Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, et al. Prevention of VTE in Orthopedic Surgery Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb 1;141(2, Supplement):e278S-e325S.
Jannelli E, Castelli A, Ferranti Calderoni E, Annunziata S, Maccario G, Ivone A, et al. Fractures in Patients With COVID-19 Infection: Early Prognosis and Management. A Case Series of 20 Patients in a Single Institution in Lombardy, Northern Italy. J Orthop Trauma. 2020 Oct;34(10):e389–97.
Ciceri F, Beretta L, Scandroglio AM, Colombo S, Landoni G, Ruggeri A, et al. Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis. Crit Care Resusc J Australas Acad Crit Care Med. 2020 Apr 15;22(2):95–7.
Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost JTH. 2020 May;18(5):1094–9.
Kumar Jain V, Lal H, Kumar Patralekh M, Vaishya R. Fracture management during COVID-19 pandemic: A systematic review. J Clin Orthop Trauma. 2020 Jul;11(Suppl 4):S431–41.
M V, U P-B, M P-L, Ja R-C. Factors associated with mortality due to trochanteric fracture. A cross-sectional study. Orthop Traumatol Surg Res OTSR. 2020 Jan 8;106(1):135–9.
Giannoudis PV, van Griensven M, Hildebrand F, Krettek C, Pape H-C. Femoral Nailing-related Coagulopathy Determined by First-hit Magnitude. Clin Orthop. 2008 Feb;466(2):473–80.
Hines CB. Understanding Bone Cement Implantation Syndrome. AANA J. 2018 Dec;86(6):433–41.
Mazidi M, Shivappa N, Wirth MD, Hebert JR, Vatanparast H, Kengne AP. The association between dietary inflammatory properties and bone mineral density and risk of fracture in US adults. Eur J Clin Nutr. 2017 Nov;71(11):1273–7.
Mi B, Chen L, Tong D, Panayi AC, Ji F, Guo J, et al. Delayed surgery versus nonoperative treatment for hip fractures in post-COVID-19 arena: a retrospective study of 145 patients. Acta Orthop. 2020 Sep;1–5.
Spandorfer J, Galanis T. In the Clinic. Deep venous thrombosis. Ann Intern Med. 2015 May 5;162(9):ITC1.
Sinvani L, Goldin M, Roofeh R, Idriss N, Goldman A, Klein Z, et al. Implementation of Hip Fracture Co-Management Program (AGS CoCare: Ortho®) in a Large Health System. J Am Geriatr Soc. 2020 Aug;68(8):1706–13.
Chang Liang Z, Wang W, Murphy D, Po Hui JH. Novel Coronavirus and Orthopaedic Surgery: Early Experiences from Singapore. J Bone Joint Surg Am. 2020 May 6;102(9):745–9.
Bath J, Smith JB, Kruse RL, Vogel TR. Neutrophil-lymphocyte ratio predicts disease severity and outcome after lower extremity procedures. J Vasc Surg. 2020 Aug;72(2):622–31.
