Preoperative echocardiogram does not increase time to surgery in hip fracture patients with prior percutaneous coronary intervention

Assefa, Tensae; Esper, Garrett W.; Cavaleri, Salvatore G.; Furgiuele, David; Konda, Sanjit R.; Littlefield, Connor P.

doi:10.1007/s00590-022-03245-8

Cited by 1 publication

(1 citation statement)

References 30 publications

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“…All centers within our institution followed a similar four-day hip fracture treatment protocol [16][17][18]. For this study, patient injuries were classified based on Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classifications and included intertrochanteric (AO/OTA 31A), femoral neck (AO/OTA 31B), and subtrochanteric (AO/OTA 32(A-C)) hip fractures [19].…”

Section: Methodsmentioning

confidence: 99%

Hip Fracture Care during COVID-19: Evolution through the Pandemic

Konda¹,

Esper²,

Meltzer-Bruhn³

et al. 2023

Cureus

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Introduction:The purpose of this epidemiologic study was to analyze the care provided by our institution to middle-aged and geriatric hip fracture patients throughout the pandemic to examine for any differences compared to pre-pandemic care and across the pandemic stages.Methods: Consecutive patients >55 years old treated for hip fractures at our institution between October 2014 and January 2022 were analyzed for demographics, coronavirus disease 2019 (COVID-19) and vaccination status at admission, injury characteristics, hospital quality measures, and outcomes. Patients were divided into three separate cohorts: Pre-COVID-19 (PRECOV), COVID-19 Pre-Vaccine (PREVAX), and COVID-19 Post-Vaccine (POSTVAX). A sub-analysis removed COVID-19-positive patients across the study period. Comparative analyses were conducted.Results: A total of 2,633 hip fracture patients were included. For the overall cohort, there was no difference in the rate of inpatient deaths between the PRECOV, PREVAX, and POSTVAX cohorts (p=0.278). PRECOV had a significantly lower 30-day mortality rate compared to PREVAX or POSTVAX (p=0.012). Differences in complication rates for surgical site infection, urinary tract infection, and anemia (p<0.01 for all) were seen between cohorts. PRECOV had the longest length of hospital stay (p<0.01). PREVAX patients required more ICU level of care (p<0.01). When removing COVID-19-positive patients, all three cohorts had similar inpatient (p=0.872) and 30-day mortality rates (p=0.130). Conclusion:The care of patients treated for hip fractures did not change throughout the pandemic at our institution. The elevated mortality rate due to the effects of COVID-19 seen in the pre-vaccine cohort decreased over time as the understanding of COVID-19 improved and the vaccine was introduced. We recommend continuation of the same hip fracture care protocols as used pre-pandemic.

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