COVID-19 Vaccination: Does It Alter Postoperative Mortality and Morbidity in Hip Fractures?

Abstract

Introduction The primary aim of our study was to evaluate the impact of coronavirus disease 2019 (COVID-19) vaccination on mortality in patients with hip fractures by comparing it to those who are unvaccinated. Our secondary objective was to compare the impact on postoperative morbidity parameters like length of hospital stay and complications. Methods A total of 619 hip fractures were divided into the 'Vaccinated group' consisting of 300 patients who had COVID-19 vaccination and the 'Unvaccinated group' consisting of 319 patients who were not vaccinated. Patient demographic variables, Nottingham hip fracture score, American Society of Anesthesiologists ( ASA ) grade, type of anaesthesia used, and Charlson Comorbidity Index were collected. Our primary outcome measures were 30- and 90-day mortality. Secondary outcome measures included postoperative complications like thromboembolic complications, cardiac, and respiratory complications, etc. Mortality among the COVID-positive patients was also compared between the groups. Results Thirty-day postoperative mortality was higher in the unvaccinated group at 13.2% than in the vaccinated group at 5.3%. A similar increase in 90-day mortality was also observed in the unvaccinated group at 24.8% when compared to 14.7% in the vaccinated group(p<0.001). Despite having a higher baseline prevalence of cardiac comorbidities, the Vaccinated group had fewer post-operative cardiac, thromboembolic, and neurological complications (p>0.05). Moreover, electrolyte imbalance and AKI were also seen in fewer patients in the vaccinated group compared to the control group (p<0.05). Furthermore, it was found that among the vaccinated patients who did have perioperative COVID-19 infection, the 30-day mortality was significantly lower (10%) compared to the control group (31.2%) (p<0.001). Similarly, 90-day mortality was significantly lower (25%) compared to the control group (43.75%) (p<0.001). Conclusion Vaccination against COVID-19 independently reduced mortality and morbidity among patients with hip fractures when compared to those who are not vaccinated. Furthermore, it decreased the risk of acquiring COVID-19, and subsequent postoperative complications. Among those who are infected with COVID-19 despite vaccination, the mortality was significantly lesser.

COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels?

“…reported the increased mortality risk in COVID-19 hip fracture patients persisted despite treated surgically [ 33 ]. A few studies also reported on the 90-day mortality rate, which ranged from 14.7% to 67% [ [34] , [35] , [36] ]. Our study demonstrated 90-day mortality rate of 21.4% in COVID-19 hip fracture patients in the Chinese population, which is consistent with overseas studies.…”

Preoperative COVID-19 Vaccination is Associated with Decreased Perioperative Mortality after Major Vascular Surgery

“…COVID-19 vaccination has been associated with improved outcomes, including decreased mortality, in patients undergoing various surgical procedures, such as cardiovascular, gastrointestinal operations and orthopedic surgeries. [11][12][13] However, there is a paucity of literature evaluating the effect of COVID-19 vaccination on perioperative outcomes after major vascular surgery, specifically. In this retrospective cohort study, we utilized the Society for Vascular Surgery Vascular Quality Initiative (SVS-VQI) database to examine national trends in perioperative mortality after major vascular surgery in the post-vaccination stage of the pandemic.…”