Outcomes of COVID-19 Negative Hip Fracture Patients During the Acute and Subacute Pandemic

Onizuka, Naoko; Topor, Lauren; Schroder, Lisa K.; Switzer, Julie A.

doi:10.1177/21514593211006692

Cited by 12 publications

(16 citation statements)

References 37 publications

(50 reference statements)

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“…In comparison with previously reported data on hip fractures during the COVID-19 pandemic in an elderly population at a community hospital, [ 18 ] there were no statistically significant differences in demographics or comorbidities between patients at the trauma center and patients at the community hospital (data not shown). In contrast to our findings from the level 1 trauma center, the authors found that TTS and LOS increased during the pandemic in the community hospital.…”

Section: Resultsmentioning

confidence: 45%

“…The length of stay varied widely around the world during the pandemic. Some studies report an increased LOS during the COVID-19 pandemic, [ 18 , 35 ] while others found a decreased LOS, [ 10 , 24 ] or no significant difference between periods. [ 9 , 33 ] We attribute these wide-ranging results to differing hospital-by-hospital protocols and workload effects of the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…The methods described above (including time periods, inclusion and exclusion criteria, and variables) are identical and approved under the same IRB. [ 18 ]…”

Section: Methodsmentioning

confidence: 99%

“…Lebrun et al (August, 2020) [36] United States March 20, 2020 to April 24, 2020 59 ↑ (P = .001) ND (P = .43) ND (P = .11) Minneapolis/St. Paul Community Hospital (March, 2021) [18] United States January 17, 2020 to July 02, 2020 125 ND (P = .34) ↑ (P = .034) ND (P = .17 Table 3 Trauma center and community hospital [18] pre-Covid (A) to post-Covid (B/C) pair-wise comparisons…”

Section: Asiamentioning

confidence: 99%

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Hip fracture care during the COVID-19 pandemic: retrospective cohort and literature review

Topor

Wood

Switzer

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objectives: The goal of this study was to investigate whether the COVID-19 pandemic has affected hip fracture care at a Level I Trauma hospital. The secondary goal was to summarize the published hip fracture reports during the pandemic. Design: A retrospective cohort study. Setting: Level I Trauma Center. Patients/Participants: Eighty-six operatively treated hip fracture patients age ≥65 years, occurring from January 17 to July 2, 2020. Intervention (if any): N/A. Main Outcome Measurements: We defined 3 phases of healthcare system response: pre-COVID-19 (period A), acute phase (period B), and subacute phase (period C). The primary outcome was 30-day mortality. Clinical outcomes including time to surgery (TTS) and length of stay (LOS) were extracted from the electronic medical record. Results: Twenty-seven patients from Period A, 27 patients from Period B, and 32 patients from Period C were included. The 30-day mortality was not statistically different. The mean TTS was 20.0 +/− 14.3 hours and was the longest in Period C (22.1 +/− 9.8 hours), but the difference was not statistically significant. The mean LOS was 113.0 +/− 66.2 hours and was longest in Period B (120.9 +/− 100.6 hours). However, the difference was not statistically significant. Conclusions: The 30-day mortality, TTS, and LOS were not statistically different across multiple phases of pandemic at a level 1 trauma center. Our results suggest that we successfully adapted new protocol changes and continued to provide evidence-based care for hip fracture patients. Our results were comparable with that of other authors around the world.

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Section: Resultsmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

“…The methods described above (including time periods, inclusion and exclusion criteria, and variables) are identical and approved under the same IRB. [ 18 ]…”

Section: Methodsmentioning

confidence: 99%

Section: Asiamentioning

confidence: 99%

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Hip fracture care during the COVID-19 pandemic: retrospective cohort and literature review

Topor

Wood

Switzer

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

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“…Studies indicated that late presentation and delayed surgery increased complications and 30-day mortality. 39,40 In our study, the length delay of presentation with hip fractures in the elderly was 7 days, and we encountered postoperative infection and no mortality. Our sample was too small for us to make a conclusion regarding this matter.…”

mentioning

confidence: 55%

COVID-19 Pandemic Impact on Orthopaedic Trauma Practice: A Global Perspective

Al-Omran¹

2022

ORR

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Background and Objective We conducted a systematic review to evaluate the global impact on orthopaedic trauma admissions during the COVID-19 crisis and compare it to that in Saudi Arabia. Methods We conducted an extensive search of the PubMed and the Cochrane Central Register of Clinical Trials databases for articles published on orthopaedic trauma during the pandemic. We used the terms “orthopaedic trauma”, “coronavirus”, “covid-19”, and “Sars-cov-2” for the search. We retrieved data to assess the impact of COVID-19 on orthopaedic and trauma patients attending hospitals during the pandemic. Secondary outcomes included reports from various regions of the world, differences in patient age, gender, and comparison to the nonlockdown period. We excluded questionnaires, surveys, reviews, and meta-analyses. The studies were divided based on where they were conducted: the Americas; the United Kingdom; Europe; Asia; the Middle East; and Australia, including New Zealand. Results We retrieved 763 studies using the keywords and initially analyzed 70. We chose 23 studies for final analysis, which were all retrospective studies, from which we extracted 50% of our preset data. These articles included 16,383 patients who sought advice related to orthopaedic and trauma necessities during the pandemic. Before the pandemic, 61,559 patients sought advice for orthopaedic and trauma necessities. Most of the reports focused on adults, and in three studies, researchers reported on paediatric on orthopaedic patients. The average decrease in patients seeking orthopaedic and trauma assistance during the pandemic was 45.5 ± 20.4 (range 18.9–86%, p < 0.001). The largest decrease in patients seeking advice occurred in Asia (>60%), and the lowest occurred in Australia and New Zealand (about 20%, p < 0.001). Conclusion Presentations of orthopaedic trauma during the COVID-19 during pandemic lockdown was less but not as profoundly as one may have expected.

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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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Outcomes of COVID-19 Negative Hip Fracture Patients During the Acute and Subacute Pandemic

Cited by 12 publications

References 37 publications

Hip fracture care during the COVID-19 pandemic: retrospective cohort and literature review

Hip fracture care during the COVID-19 pandemic: retrospective cohort and literature review

COVID-19 Pandemic Impact on Orthopaedic Trauma Practice: A Global Perspective

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

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