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

Zamora, Tomás; Sandoval, Felipe; Demandes, Hugo; Serrano, Javier; Gonzalez, J. L. V.; Lira, María Jesús; Klaber, Ianiv; Carmona, Maximiliano; Botello, Eduardo; Schweitzer, Daniel

doi:10.1177/21514593211024509

Cited by 10 publications

(12 citation statements)

References 33 publications

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“…By way of example, the rate of UTI in our study compared between the pre-pandemic and pandemic periods was 27 (13.7%) versus 64 (22.3%) ( p = 0.024). Our overall rate of UTI was 18.8%, which is comparable with the rates reported from previous studies (range, 8.3–24.0%) [ 23 , 38 – 40 ]. At our center, we do not routinely record the duration that an indwelling urinary catheter is retained; however, our hip fracture protocol during both the pre-pandemic and pandemic periods was to remove a urinary catheter on postoperative day 2 or when the hip fracture patient can ambulate out of bed.…”

Section: Discussionsupporting

confidence: 90%

Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period

et al. 2022

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The COVID-19 pandemic adversely affected the functional outcomes of fragility hip fracture patients. This study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among patients treated during the pandemic. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods. Introduction This study aims to investigate the in-hospital complication rate and short-term postoperative functional outcomes of fragility hip fracture (FHF) patients compared between during the COVID-19 pandemic and the same 14-month time period 1 year prior to the pandemic. Methods Using data from the Siriraj Fracture Liaison Service registry, FHF patients treated during the COVID-19 pandemic (1 March 2020 to 30 April 2021) were time-matched with FHF patients treated during the pre-pandemic period (1 March 2018 to 30 April 2019). We collected the rate of in-hospital postoperative complications and the postoperative functional outcomes at discharge and 3 months as measured by the Barthel Index (BI) and EuroQol visual analog scale (EQ-VAS). Functional outcome measures were compared between the pre-pandemic and pandemic periods. Results There were 197 and 287 patients in the pre-pandemic and pandemic groups, respectively. At the 3-month postoperative follow-up, the mean postoperative BI score and change in BI score were both significantly lower in the pandemic group indicating poorer postoperative function. Moreover, FHF patients treated during the pandemic had significantly more inhospital complications (36.6% vs. 22.8%, p = 0.002). There was no significant difference in the 3-month EQ-VAS or change in the EQ-VAS between groups. ConclusionThe results of this study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among FHF patients treated during the COVID-19 pandemic compared to the pre-pandemic period. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods.

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Section: Discussionsupporting

confidence: 90%

Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period

et al. 2022

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“…Overall, patients who experienced hip fragility fractures in the 2020 pandemic had a greater mortality compared to the same period of the pre-pandemic era [ 65 , 66 ]. COVID infection directly contributed to increase the 30- and 90-day mortality following fragility hip fractures, not explained by patient characteristics [ 67 – 70 ]. Moreover, a longer time span from injury to surgical treatment and a longer hospitalisation was evidenced in comparison to the preceding year 2019, when the pandemic began [ 71 ].…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic, trauma surgery, and Covid-2019 pandemic: clinical panorama and future prospective in Europe

Migliorini

Weber

Pappalardo

et al. 2022

Eur J Trauma Emerg Surg

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Purpose This study investigated the impact of the Covid-19 pandemic in Europe on consultations, surgeries, and traumas in the field of orthopaedic and trauma surgery. Strategies to resume the clinical activities were also discussed. Methods This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. All the comparative studies reporting data on the impact of Covid-19 in the field of orthopaedic and trauma surgery in Europe were accessed. Only comparative clinical studies which investigated the year 2020 versus 2019 were eligible. Results 57 clinical investigations were included in the present study. Eight studies reported a reduction of the orthopaedic consultations, which decreased between 20.9 and 90.1%. Seven studies reported the number of emergency and trauma consultations, which were decreased between 37.7 and 74.2%. Fifteen studies reported information with regard to the reasons for orthopaedic and trauma admissions. The number of polytraumas decreased between 5.6 and 77.1%, fractures between 3.9 and 63.1%. Traffic accidents admissions dropped by up to 88.9%, and sports-related injuries dropped in a range of 59.3% to 100%. The overall reduction of the surgical interventions ranged from 5.4 to 88.8%. Conclusion The overall trend of consultations, surgeries, and rate of traumas and fragility fractures appear to decrease during the 2020 European COVID pandemic compared to the pre-pandemic era. Given the heterogeneities in the clinical evidence, results from the present study should be considered carefully. Level of evidence Level IV, systematic review.

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“…A higher mortality rate has been described in older individuals infected with COVID-19 [ 4 ]. In several studies, early mortality at 30 and 90 days increased significantly [ 1 , 3 ] between 30 and 60% according to different published series [ 4 , 21 , 24 , 25 ]. In a Spanish multicenter study [ 24 ], the hip fracture mortality rate observed at a mean follow-up of 14 days was higher than the 30-day mortality rate reported by the Spanish National Hip Fracture Registry and in the Swedish national fracture registry.…”

Section: Discussionmentioning

confidence: 99%

“…The World Health Organization declared the COVID-19 infection a global pandemic on March 11, 2020, and Latin America, in particular, became the most affected geographic area in the world in June 2020 [ 1 ]. The COVID-19 pandemic has disproportionately affected older adults, who, due to their frailty and associated comorbidities, proved to be the most vulnerable affected population; thus, the hospitalized elderly accounted worldwide for almost half of the deaths due to COVID-19 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Decreasing incidence rates of osteoporotic hip fractures in Ecuador during the COVID-19 pandemic

Gavilánez

Chávez²,

Gavilanes

et al. 2022

Arch Osteoporos

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Summary We aimed at comparing the incidence of hip fractures in older adults from Ecuador before and during the COVID-19 pandemic. There was a significant reduction in the number of hip fractures, with no change in the length of hospital stay, mortality, and case-fatality rate, during the period of social isolation. Introduction The impact that the COVID-19 pandemic has had on fragility fractures is being recently evaluated in the literature. Despite this, data from Latin America in this regard is scarce. Purpose This study aims to compare the incidence rate of hip fractures before and during the COVID-19 pandemic in older adults who received care in the public and private health system of Ecuador. Methods This was a descriptive and retrospective study that analyzed data of individuals aged 60 years and older who had hip fractures before and during the COVID-19 pandemic. The information was obtained from the National Hospital Discharge Yearbook. We calculated the incidence, average length of hospital stay, mortality, and case-fatality rate associated with hip fractures. Results There was a significant reduction in the incidence of hip fractures in adults 60 or older during the period of social isolation due to COVID-19. Between March and December 2019, there was an incidence of 152 hip fractures per 100,000 inhabitants, whereas during the same period but in 2020 in the incidence was 110 per 100,000 inhabitants ( p < 0.0001). The main decrease was observed in women aged 80 or more. The average length of hospital stay did not show significant changes. Mortality displayed a non-significant decrease ( p = 0.14), although this decrease was significant among women ( p = 0.02). Case-fatality rate showed a non-significant increase for the whole group ( p = 0.68) and for men ( p = 0.09). Conclusion Hip fracture rates decreased significantly in adults aged 60 and older in 2020 compared to 2019. This decrease of hip fracture incidence rates was mainly due to the reductions observed in older people and women. The average length of hospital stay, mortality, and case-fatality rate associated with hip fractures did not show significant changes during the pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s11657-022-01202-w.

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

Cited by 10 publications

References 33 publications

Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period

Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period

Orthopaedic, trauma surgery, and Covid-2019 pandemic: clinical panorama and future prospective in Europe

Decreasing incidence rates of osteoporotic hip fractures in Ecuador during the COVID-19 pandemic

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