Comparing the 30-Day Mortality for Hip Fractures in Patients with and without COVID-19: An Updated Meta-Analysis

Abstract

We conducted an updated meta-analysis to evaluate the 30-day mortality of hip fractures during the COVID-19 pandemic and assess mortality rates by country. We systematically searched Medline, EMBASE, and the Cochrane Library up to November 2022 for studies on the 30-day mortality of hip fractures during the pandemic. Two reviewers used the Newcastle–Ottawa tool to independently assess the methodological quality of the included studies. We conducted a meta-analysis and systematic review including 40 eligible studies with 17,753 patients with hip fractures, including 2280 patients with COVID-19 (12.8%). The overall 30-day mortality rate for hip fractures during the pandemic was 12.6% from published studies. The 30-day mortality of patients with hip fractures who had COVID-19 was significantly higher than those without COVID-19 (OR, 7.10; 95% CI, 5.51–9.15; I2 = 57%). The hip fracture mortality rate increased during the pandemic and varied by country, with the highest rates found in Europe, particularly the United Kingdom (UK) and Spain. COVID-19 may have contributed to the increased 30-day mortality rate in hip fracture patients. The mortality rate of hip fracture in patients without COVID-19 did not change during the pandemic.

Mortality Rate and Outcomes of Omicron Variant Positive Patients with Osteoporotic Fractures: A Retrospective Study

“…[11] Various meta-analyses reported a wide range of COVID-19 hip fracture mortality rates across nations: UK 14.3%, Spain 14.90%, Italy 9.6%, and the USA 6.2%. [13][14][15] However, there has been conflicting literature that reported similar mortality rates between the COIVD-19 positive and negative patients who have undergone surgery as well as a recent trend of decrease in mortality rates between the two groups. [16][17][18][19] A meta-analysis review done by Tripathy et al [18] reported that there was no significant difference in the 30-day mortality rate between the pre-pandemic and pandemic periods.…”

“…In Europe, shortages of hospital beds, medical supplies, and healthcare providers during the early COVID-19 pandemic made it difficult for patients with hip fractures to access healthcare, which consequently affected the mortality rate. [15] In this study, screening and planning for surgery was done with minimum delay, as patients underwent surgery within 10 days after COVID-19 diagnosis during their isolation period. Numerous kinds of literature have pointed out the importance of healthcare accessibility and time to operation, as this could affect the clinical outcomes of the patient in mortality, postoperative complications, and recovery from ambulation.…”