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Article ; Online: Evaluating the efficacy of a two-site ('COVID-19' and 'COVID-19-free') trauma and orthopaedic service for the management of hip fractures during the COVID-19 pandemic in the UK.

Chui, Karen / Thakrar, Amit / Shankar, Shivakumar

Bone & joint open

2020 Volume 1, Issue 6, Page(s) 190–197

Abstract: Aims: Hip fracture patients are at higher risk of severe COVID-19 illness, and admission into hospital puts them at further risk. We implemented a two-site orthopaedic trauma service, with 'COVID' and 'COVID-free' hubs, to deliver urgent and infection- ... ...

Abstract	Aims: Hip fracture patients are at higher risk of severe COVID-19 illness, and admission into hospital puts them at further risk. We implemented a two-site orthopaedic trauma service, with 'COVID' and 'COVID-free' hubs, to deliver urgent and infection-controlled trauma care for hip fracture patients, while increasing bed capacity for medical patients during the COVID-19 pandemic. Methods: A vacated private elective surgical centre was repurposed to facilitate a two-site, 'COVID' and 'COVID-free', hip fracture service. Patients were screened for COVID-19 infection and either kept at our 'COVID' site or transferred to our 'COVID-free' site. We collected data for 30 days on patient demographics, Clinical Frailty Scale (CFS), Nottingham Hip Fracture Scores (NHFS), time to surgery, COVID-19 status, mortality, and length of stay (LOS). Results: In all, 47 hip fracture patients presented to our service: 12 were admitted to the 'COVID' site and 35 to the 'COVID-free' site. The 'COVID' site cohort were older (mean 86.8 vs 78.5 years, p = 0.0427) and with poorer CFS (p = 0.0147) and NHFS (p = 0.0023) scores. At the 'COVID-free' site, mean time to surgery was less (29.8 vs 52.8 hours, p = 0.0146), and mean LOS seemed shorter (8.7 vs 12.6 days, p = 0.0592). No patients tested positive for COVID-19 infection while at the 'COVID-free' site. We redirected 74% of our admissions from the base 'COVID' site and created 304 inpatient days' capacity for medical COVID patients. Conclusion: Acquisition of unused elective orthopaedic capacity from the private sector facilitated a two-site trauma service. Patients were treated expeditiously, while successfully achieving strict infection control. We achieved significant gains in medical bed capacity in response to the COVID-19 demand. The authors propose the repurposing of unused elective operating facilities for a two-site 'COVID' and 'COVID-free' model as a safe and effective way of managing hip fracture patients during the pandemic.Cite this article:
Keywords	covid19
Language	English
Publishing date	2020-06-03
Publishing country	England
Document type	Journal Article
ISSN	2633-1462
ISSN (online)	2633-1462
DOI	10.1302/2633-1462.16.BJO-2020-0035.R1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom.

Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

Journal of orthopaedic trauma

2020 Volume 34, Issue 9, Page(s) e325–e329

Abstract: Objectives: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom.: ... ...

Abstract	Objectives: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom. Methods: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from "day 0" of the COVID-19 pandemic in the United Kingdom and continued for 30 days. We collected data on time to surgery, Clinical Frailty Scale score, Nottingham Hip Fracture Score, COVID-19 infection status, 30-day mortality, and cause of death. For comparison, we collected retrospective data during the same 30-day period in 2018, 2019, and the previous 6 months (Control groups A, B, and C, respectively). Results: Forty-three patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P = 0.022), B (P = 0.003) and C (P = 0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the 7 mortalities recorded, 4 patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P = 0.002, odds ratio 2.4). Conclusions: Our study demonstrated a significant increase in 30-day mortality among hip fracture patients during the first 30 days of the COVID-19 pandemic in the United Kingdom. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality. Level of evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
MeSH term(s)	Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Female ; Fracture Fixation, Internal ; Hip Fractures/complications ; Hip Fractures/mortality ; Hip Fractures/surgery ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; Survival Rate ; Time Factors ; United Kingdom
Keywords	covid19
Language	English
Publishing date	2020-08-17
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	639099-7
ISSN	1531-2291 ; 0890-5339
ISSN (online)	1531-2291
ISSN	0890-5339
DOI	10.1097/BOT.0000000000001889
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Crash Course in Orthopaedics: Development and Evaluation of a 12-Week Online Trauma and Orthopaedics Teaching Program for Medical Students During the COVID-19 Pandemic.

James, Catherine / Chui, Karen / Brown, Alex / Poacher, Arwel / Carpenter, Claire / Jesudason, Edwin

Cureus

2022 Volume 14, Issue 8, Page(s) e28628

Abstract: Introduction The COVID-19 pandemic caused significant disruption in clinical placements of medical students in the United Kingdom (UK), including trauma and orthopaedic surgery (T&O) rotations. Based on the British Orthopaedic Association (BOA) ... ...

Abstract	Introduction The COVID-19 pandemic caused significant disruption in clinical placements of medical students in the United Kingdom (UK), including trauma and orthopaedic surgery (T&O) rotations. Based on the British Orthopaedic Association (BOA) undergraduate syllabus, a 12-week online teaching program was designed to supplement T&O teaching for medical students across the UK while lockdown and social-distancing restrictions were in place. This study aims to describe the process of designing an online teaching program, evaluate the effectiveness of online education, explore medical student perceptions of the virtual learning environment, and report the lessons learned from this 12-week online program. Methods The "Crash Course in Orthopaedics" consisted of 12 webinars, with topics covering a range of acute and chronic T&O conditions, and was delivered through the online platform Zoom. Attendees were invited to complete a post-course questionnaire retrospectively and the results were used in this study. Qualitative data was assessed using thematic analysis. Quantitative data were presented as descriptive statistics. Results The webinar series was attended by approximately 5150 participants, with the largest demographic group being clinical medical students (49%). Results from the survey revealed three broad themes which were: 1). Interactivity: question + answer (Q+A), multiple choice questions (MCQs), online tools 2). Content: case examples, orthopaedic examinations, objective structure clinical examination (OSCE) tips 3). Accessibility: slides, recordings, duration of the session. Our study found that the online teaching program improved students' clinical knowledge of T&O and they found learning through interactive methods such as polls, the chat function on zoom, and case-based discussions to be most useful. Also, from the results of this study, a guide on "How to Run a Successful Webinar Series for Medical Students" was developed. Conclusion Online webinars effectively supplement T&O teaching and experience for medical students whose T&O placements were disrupted during the COVID-19 pandemic. The results will be a helpful guide to those planning medical education webinars in the future.
Language	English
Publishing date	2022-08-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.28628
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom

Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

J Orthop Trauma

Abstract: OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom. ... ...

Abstract	OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom. METHODS: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from "day 0" of the COVID-19 pandemic in the United Kingdom and continued for 30 days. We collected data on time to surgery, Clinical Frailty Scale score, Nottingham Hip Fracture Score, COVID-19 infection status, 30-day mortality, and cause of death. For comparison, we collected retrospective data during the same 30-day period in 2018, 2019, and the previous 6 months (Control groups A, B, and C, respectively). RESULTS: Forty-three patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P = 0.022), B (P = 0.003) and C (P = 0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the 7 mortalities recorded, 4 patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P = 0.002, odds ratio 2.4). CONCLUSIONS: Our study demonstrated a significant increase in 30-day mortality among hip fracture patients during the first 30 days of the COVID-19 pandemic in the United Kingdom. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #732070
Database	COVID19

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Article: 30-day Mortality Rate of Patients with Hip Fractures during the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom

Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

J. orthop. trauma

Abstract: OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first thirty days of the pandemic in the UK. METHODS: A ... ...

Abstract	OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first thirty days of the pandemic in the UK. METHODS: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from 'day zero' of the COVID-19 pandemic in the UK and continued for thirty days. We collected data on time-to-surgery, Clinical Frailty Scale (CFS) score, Nottingham Hip Fracture Score (NHFS), COVID-19 infection status, 30-day mortality and cause of death. For comparison, we collected retrospective data during the same thirty-day period in 2018, 2019 and the previous six months (Control groups A, B and C, respectively). RESULTS: 43 patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P=0.022), B (P=0.003) and C (P=0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the seven mortalities recorded, four patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P=0.002, odds ratio 2.4). CONCLUSIONS: Our study demonstrated a significant increase in 30-day mortality amongst hip fracture patients during the first thirty days of the COVID-19 pandemic in the UK. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #641504
Database	COVID19

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Article ; Online: Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic

Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

Journal of Orthopaedic Trauma

A Single Centre Prospective Study in the United Kingdom

2020 Volume 34, Issue 9, Page(s) e325–e329

Keywords	Surgery ; Orthopedics and Sports Medicine ; General Medicine ; covid19
Language	English
Publisher	Ovid Technologies (Wolters Kluwer Health)
Publishing country	us
Document type	Article ; Online
ZDB-ID	639099-7
ISSN	0890-5339
ISSN	0890-5339
DOI	10.1097/bot.0000000000001889
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Trauma and orthopaedic team members' mental health during the COVID-19 pandemic: results of a UK survey.

Thakrar, Amit / Raheem, Ali / Chui, Karen / Karam, Edward / Wickramarachchi, Lilanthi / Chin, Kuen

Bone & joint open

2020 Volume 1, Issue 6, Page(s) 316–325

Abstract: Aims: Healthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&O) has experienced ... ...

Abstract	Aims: Healthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&O) has experienced cancellation of routine clinics and operating, with redistribution of the workload and human resources. To date, no studies have evaluated the mental health impact of these changes on the T&O workforce. We report the results of a novel survey on the impact of the pandemic on the mental health of our orthopaedic workforce and the contributory factors. Methods: A 20-question survey-based cross-sectional study of orthopaedic team members was conducted during the COVID-19 pandemic. The primary objective was to identify the impact of the pandemic on mental health in the form of major depressive disorder (MDD) and general anxiety disorder (GAD). The survey incorporated the patient health questionnaire (PHQ-2), which is validated for screening of MDD, and the generalized anxiety disorder questionnaire (GAD-2), which is validated for screening of GAD. Results: There were 62 respondents (18 females and 44 males). As compared to the general population, we noted a greater estimated prevalence of GAD (17.7% vs 5.9%, p = 0.0009297) and MDD (19.4% vs 3.3%, p = 0.0000007731). The prevalence of MDD symptoms was greatest among senior house officers (SHOs) (p = 0.02216). Female respondents scored higher for symptoms of MDD (p = 0.03583) and GAD (p = 0.0001086). Those identifying as 'Black, African, Caribbean or Black British' displayed a higher prevalence of GAD symptoms (p = 0.001575) and felt least supported at work (p = 0.001341). Conclusion: Our study, in the first of its kind, shows a significant prevalence of GAD and MDD in the workforce. We found that SHOs, females and those of Black, African, Caribbean, or Black British origin were disproportionately affected. Action should be taken to help prevent adverse mental health outcomes for our colleagues during the pandemic.Cite this article:
Keywords	covid19
Language	English
Publishing date	2020-11-01
Publishing country	England
Document type	Journal Article
ISSN	2633-1462
ISSN (online)	2633-1462
DOI	10.1302/2046-3758.16.BJO-2020-0053.R1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Knee salvage procedures: The indications, techniques and outcomes of large osteochondral allografts.

Chui, Karen / Jeys, Lee / Snow, Martyn

World journal of orthopedics

2015 Volume 6, Issue 3, Page(s) 340–350

Abstract: The overall incidence of osteochondral defect in the general population is estimated to be 15 to 30 per 100000 people. These lesions can become symptomatic causing pain, swelling and decreased function of the knee, and may eventually progress to ... ...

Abstract	The overall incidence of osteochondral defect in the general population is estimated to be 15 to 30 per 100000 people. These lesions can become symptomatic causing pain, swelling and decreased function of the knee, and may eventually progress to osteoarthritis. In the young and active population, partial or total knee arthroplasty (TKA) is rarely the treatment of choice due to risk of early failure. Osteochondral allograft transplantation has been demonstrated to be a safe and effective treatment of large osteochondral and chondral defects of the knee in appropriately selected patients. The treatment reduces pain, improves function and is a viable limb salvage procedure for patients, especially young and active patients for whom TKA is not recommended. Either large dowels generated with commercially available equipment or free hand shell allografts can be implanted in more posterior lesions. Current recommendations for fresh allografts stored at 4C advise implantation within 21-28 d of procurement for optimum chondrocyte viability, following screening and testing protocols. Higher rates of successful allograft transplantation are observed in younger patients, unipolar lesions, normal or corrected malalignment, and defects that are treated within 12 mo of symptom onset. Patients with bipolar lesions, uncorrectable malalignment, advanced osteoarthritis, and those over 40 tend to have less favourable outcomes.
Language	English
Publishing date	2015-04-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2649712-8
ISSN	2218-5836
ISSN	2218-5836
DOI	10.5312/wjo.v6.i3.340
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Amputation for osteomyelitis in a patient with spina bifida.

Chui, Karen K M / Newman, Jeremy / Hobbs, Simon D / Garnham, Andrew W / Wall, Michael L

Journal of surgical case reports

2018 Volume 2018, Issue 11, Page(s) rjy319

Abstract: We describe a case of osteomyelitis in a patient with spina bifida presenting to the vascular surgeon and highlight the complex challenges encountered. We review the literature and demonstrate how good multidisciplinary care and early consideration for ... ...

Abstract	We describe a case of osteomyelitis in a patient with spina bifida presenting to the vascular surgeon and highlight the complex challenges encountered. We review the literature and demonstrate how good multidisciplinary care and early consideration for surgical amputation may benefit this unique group of patients.
Language	English
Publishing date	2018-11-27
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjy319
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Systematically capturing and acting on insights from front-line staff: the 'Bedside Learning Coordinator'.

Shand, Jenny / Allwood, Dominique / Lee, Nicole / Elahi, Noor / McHenry, Iain / Chui, Karen / Tang, Sophie / Dawson-Couper, Zoe / Mountford, James / Bohmer, Richard

BMJ quality & safety

2021 Volume 30, Issue 6, Page(s) 509–512

MeSH term(s)	Humans ; Leadership ; Organizational Culture ; Safety Management
Language	English
Publishing date	2021-02-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2592909-4
ISSN	2044-5423 ; 2044-5415
ISSN (online)	2044-5423
ISSN	2044-5415
DOI	10.1136/bmjqs-2020-011966
Database	MEDical Literature Analysis and Retrieval System OnLINE

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