Impact of COVID-19 on hip fracture care in Ireland: findings from the Irish Hip Fracture Database

Brent, Louise; Ferris, Helena; Sørensen, Jan; Valentelyte, Gintare; Kelly, Fionnola; Hurson, Conor; Ahern, Emer

doi:10.1007/s41999-021-00600-6

Cited by 11 publications

(8 citation statements)

References 8 publications

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“…Likewise, the LOS in the hospital, and hospitalization/mortality rates in the ED were similar in the pandemic (25.8%) and pre-pandemic periods (22.8%) in the present study whereas mortality rates in ED at both periods were quite low. In a study from Ireland, there were reductions in admissions, and compliance with many of the Irish Hip Fracture Standards, LOS during the pandemic, but in-hospital mortality was similar in pre-pandemic and pandemic periods [41]. In contrary, in a meta-analysis, it was shown that COVID-19 increased the risk of mortality in patients with hip fractures [42].…”

Section: Discussionmentioning

confidence: 97%

Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods

Arslan

Saraç

Ersel

et al. 2023

Preprint

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Purpose This study aimed to investigate the clinical characteristics, presentations, outcomes, and healthcare costs of older patients who presented at the emergency department (ED) with falls in the periods before and during the Coronavirus disease-2019 (COVID-19) pandemic.Methods Hospital records one year before and after the onset of the COVID-19 pandemic were retrospectively analyzed through “International Statistical Classification of Diseases-10th Revision” codes. Age, gender, falls, triage classification, length of stay (LOS) in the hospital and ED, COVID-19 status, Glasgow coma scale (GCS), consultations-comorbidities, injury status, outcomes in the ED, and costs were recorded.Results The study comprised of 3,187 patients aged ≥ 65 years admitted to the ED of a university hospital between March 2019 and 2021. In terms of pre-pandemic and pandemic periods; older patients presenting with falls to the ED, consultations, Charlson Comorbidity Index (CCI), and LOS in ED were lower in the pandemic period, but costs were higher (p = 0.03, p = 0.01, p = 0.01, p = 0.01 and p = 0.02, respectively). Hospitalization/mortality rates were higher in COVID-19-positive patients (77.2%) than in COVID-19-negative patients (4.6%) within the pandemic period and the patients in the pre-pandemic period (22.8%), likewise for the costs (both p = 0.01).Conclusion Though the number of geriatric fall presentations to ED, comorbidity burden, consultations, and LOS in the ED was lower, direct costs were higher during the pandemic period, particularly for COVID-19 positive older patients admitted to ED with falls than the pre-pandemic period, and those patients were with poorer outcomes.

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Section: Discussionmentioning

confidence: 97%

Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods

Arslan

Saraç

Ersel

et al. 2023

Preprint

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“…da Silva et al 9 found that the incidence of hip fracture patients over 60 years of age decreased in 2020 compared to 2019 in the analysis of the Brazilian public health care system. Brent et al 8 reported that hip fracture incidence in 2020 decreased by 15% compared to that in 2019 in the analysis of the Irish Hip Fracture Database. Because the lockdown period differed in each country and there are differences in ethnic, region and medical policy, the various results of these studies should not be simply compared and should not be interpreted as general trends in COVID pandemic.…”

Section: Discussionmentioning

confidence: 99%

“… 21 26 27 In addition, comparative studies of mortality rates of hip fracture with COVID-19 negative before and after the COVID-19 pandemic reported no significant increase in the mortality rate. 8 13…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies reported different results. 6 7 8 9 10 11 These differences might be related with the proportion of COVID-19 patients, the severity of COVID-19 infection, and the difference in access to medical care due to lockdown among countries. 3 9 12 13 In addition, most studies were single-center short-term comparative research studies, which might have selection bias 6 14 and might not reflect the changing patterns before and after the pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the Effects of COVID-19 on Hip Fractures in Korea Without Lockdown: Interrupted Time Series Analysis Using a Nationwide Cohort

et al. 2023

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Background The purpose of this study was to investigate the change in the incidence rate, length of hospital stay (LOS), in-hospital mortality rate, and surgical method of hip fractures during the coronavirus disease 2019 (COVID-19) pandemic in South Korea where lockdown restrictions were not implemented. Methods We calculated the expected values of the incidence of hip fractures, in-hospital mortality and LOS of hip fracture patients in 2020 (COVID period) based hip fracture database of the Korean National Health Insurance Review and Assessment (HIRA) during a 9-year period from 2011 to 2019 (pre-COVID period). A generalized estimating equation model with Poisson distribution and logarithmic link function was used to estimate adjusted annual percent change (PC) of incidence rate and 95% confidence intervals (CIs). Then, we compared the annual incidence, in-hospital mortality rate and LOS in 2020 with the expected values. Results The overall incidence rate of hip fracture in 2020 was not significantly different from the expected value (PC, −5%; 95% CI, −13 to 4; P = 0.280). In women, the incidence rate of hip fracture in age groups over 70 years was smaller than the predicted value ( P < 0.001). The in-hospital mortality rate was not significantly different from the expected value (PC, 5%; 95% CI, −8 to 19; P = 0.461). The mean LOS was larger than the expected value by 2% (PC, 2%; 95% CI, 1 to 3; P < 0.001). In intertrochanteric fracture, the proportion of internal fixation was smaller than the predicted value by 2% (PC, −2%; 95% CI, −3 to −1; P < 0.001), and that of hemiarthroplasty was larger than the predicted value by 8% (PC, 8%; 95% CI, 4 to 14; P < 0.001). Conclusions In 2020, the incidence rate of hip fracture did not significantly decrease, and in-hospital mortality rate did not significantly increase compared to the expected rates, which were projected based on the HIRA hip fracture data from 2011 to 2019. Only LOS increased slightly.

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“…As mentioned earlier, two days is the recommended time limit for patient presentation for hip surgery, especially when the patient is 65 years old or older. Brent et al [34] observed a 15% reduction in admissions for hip surgery and a decrease in compliance with many sur-gery standards following the COVID-19 pandemic in Ireland. In Portugal, the hip surgery rate beyond the appropriate time was, on average, 54.4% (2017-2019), 53.0% (2020), and 51.1% (2021-2022), without expressive differences.…”

Section: U4 Number Of Hip Surgeries Beyond 48h After Fracturementioning

confidence: 99%

Evaluating Portuguese Public Hospitals Performance: Any Difference Before and During COVID-19?

Nunes¹,

Marques²

2022

Preprint

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COVID-19 is a well-known respiratory disease spreading worldwide since January 2020, causing many deaths and massive pressure on health systems. This pandemic’s appearance compromised the health services’ sustainability and quality as many procedures were postponed or even canceled out, with an expected increase of adverse events like nosocomial infections, in-hospital deaths, and the worsening of the patients’ clinical status. Therefore, assessing whether the healthcare providers’ performance has changed is paramount. In this case, we evaluated the public hospitals in Portugal as the leading secondary health care providers in the country, which in turn has been highly affected by the pandemic. To this end, we developed a network Data Envelopment Analysis model serially relating efficiency and effectiveness. Using 2,795 observations from public hospitals and 18 variables, we observed consistent drops in efficiency when the pandemic started, followed by a recovery to levels above the pre-pandemic ones. Regarding effectiveness, we observed a positive trend during the evaluated period. In short, these results allow us to conclude that, apart from the great resilience of public healthcare providers, the Portuguese State was not prepared for a pandemic like COVID-19, but still the actions taken (including massive vaccination) were beneficial.

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Impact of COVID-19 on hip fracture care in Ireland: findings from the Irish Hip Fracture Database

Cited by 11 publications

References 8 publications

Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods

Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods

Analysis of the Effects of COVID-19 on Hip Fractures in Korea Without Lockdown: Interrupted Time Series Analysis Using a Nationwide Cohort

Evaluating Portuguese Public Hospitals Performance: Any Difference Before and During COVID-19?

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