Hip Fracture in the Elderly

Urrutia, Julio; Zamora, Tomás; Klaber, Ianiv

doi:10.1177/1179553017703998

Cited by 2 publications

(2 citation statements)

References 108 publications

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“…Hip fractures are the most severe manifestation of so-called fragility fractures and have been recognized as one of the growing epidemics of the 21st century. 4,5 Their timesensitive need for intervention and the elderly, frail, high-risk population that they affect have become critical features during the COVID-19 pandemic, especially in highly affected countries and on the verge of collapse health systems.…”

Section: Introductionmentioning

confidence: 99%

Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up

Zamora

Sandoval

Demandes

et al. 2021

Geriatr Orthop Surg Rehabil

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Introduction: Hip fracture patients have been severely affected by the COVID-19 pandemic; however, the sub acute effects of a concomitant SARS-CoV-2 infection and the outcomes in highly exposed developing countries are still unknown. Our objective is to describe the morbidity and mortality of elderly patients admitted for a hip fracture during the COVID-19 pandemic in Chile, with a minimum 90-day follow-up. Also, to elucidate predictors for mortality and to compare mortality results with the pre-pandemic era. Material and Methods: Multicentric retrospective review of patients admitted for a fragility hip fracture in 3 hospitals during the COVID-19 pandemic, and during the same time in 2019. All clinical information and images were recorded, and patients were followed for a minimum of 90-days. Morbidity and mortality were the primary outcomes. Uni/multivariable models were performed to elucidate predictors for mortality utilizing the Weibull’s regression. Results: Three hundred ninety-one cases were included. From the 2020 cohort (162 patients), 24 (15%) had a concomitant SARS-CoV-2 infection. Fourteen patients (58%) tested positive after admission. The COVID-19(+) group had a higher risk of in-hospital, 30-day, and 90-day mortality (p < 0.001). They also had a prolonged hospital stay and presented with more complications and readmissions (p < 0.05). Only COVID-19(+) status and older age were independent predictors for mortality with a HR = 6.5 (p = < 0.001) and 1.09 (p = 0.001), respectively. The 2020 cohort had twice the risk of mortality with a HR = 2.04 (p = 0.002) compared to the 2019 cohort. However, comparing only the COVID-19 (-) patients, there was no difference in mortality risk, with a HR = 1.30 (p = 0.343). Discussion: The COVID-19 pandemic has significantly affected healthcare systems and elderly patients. Conclusions: Hip fracture patients with a concomitant SARS-CoV-2 virus infection were associated with increased morbidity and mortality throughout the first 3 months. COVID-19 status and older age were significant predictors for mortality. Efforts should be directed into nosocomial infection reduction and prompt surgical management. Level of evidence: Level III

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Section: Introductionmentioning

confidence: 99%

Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up

Zamora

Sandoval

Demandes

et al. 2021

Geriatr Orthop Surg Rehabil

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“…In Nigeria, there is evidence of a rise in the incidence-rate of hip fractures among the older adults; for example, Adebajo, Cooper, and Evans (1991) reported an incidence of 2.1 per 100,000 men and 2.0 per 100,000 women at 50 years in Ibadan, while Jervas, Onwukamuche, Anyanwu, and Ugochukwu (2011) reported 10% and 17.38% incidence of hip fracture for men and women, respectively, aged more than 50 years in Owerri. This sudden rise in incidence rates is likely to come with increased hospitalization, financial burdens to family, overuse of the countries health resources, and suffering for older adults with hip fractures (Zamora, Klaber, & Urrutia, 2017). However, social factors like caregivers' burdens have been overlooked by society when compared with other factors that could affect hip fracture survivors.…”

Section: Introductionmentioning

confidence: 99%

The Burden Experience of Formal and Informal Caregivers of Older Adults With Hip Fracture in Nigeria

Diameta¹,

Adandom

Jumbo

et al. 2018

SAGE Open Nursing

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Introduction: The incidence of hip fracture among older adults in Nigeria is on the rise. As a result, there is increased frequency of hospitalization, patient suffering, family burden, and societal cost. One dimension that has not been sufficiently explored is the burden of care experienced by informal and formal caregivers. Objectives: To describe the care burden experience of informal and formal caregivers for older adults with hip fractures in a specialized orthopedic center in Nigeria and to explore in detail how their experience differs in caregiving roles. Method: This study was conducted in the phenomenological approach of qualitative methods. Face-to-face interviews and focus group interaction with 12 family caregivers and 5 health-care professionals were carried out until data saturation was achieved. Data were analyzed using thematic analysis. Results: The physical, emotional, and general health of elderly hip fracture patients are issues that affect caregiving. Factors that contribute to increased caregivers' burden include system factors (lack of personnel and health-care facilities) and patient factors: comorbidity, patient's cognitive status, and challenges completing activities of daily living (ADL). Social and financial barriers to care contribute to the type of burden experienced by the participants. Conclusions: Caregivers experience difficulty in helping patients complete their ADL because patients with hip fracture have mobility issues that are often complicated by comorbid physical and cognitive problems. Strategies to reduce caregivers' burden for older adults with hip fracture in Nigeria are needed. Greater access to health-care services and ADL aids, and training of caregivers on how to deal with cognitive and multimorbid health problems are potential solutions.

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Hip Fracture in the Elderly

Cited by 2 publications

References 108 publications

Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up

Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up

The Burden Experience of Formal and Informal Caregivers of Older Adults With Hip Fracture in Nigeria

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