Impact of the COVID-19 pandemic on osteoporotic hip fractures in Chile

Abstract

The study analyzes whether the COVID-19 pandemic affects annual hip fractures (HF) rates and weekly emergency department (ED) consultations and hospitalizations due to trauma in older people. During the COVID-19 pandemic, HF rates and ED consultation and hospitalization rates due to trauma decreased. Purpose To describe the effect of the COVID-19 pandemic on annual HF rates and weekly ED consultation and hospitalization rates due to trauma in Chile in 2020, compared to 2016-2019. Methods A retrospective study was conducted based on data from Chile's Department of Statistics and Health Information. Annual HF admissions, weekly ED consultations and hospitalizations due to trauma were described for the years 2016-2020, grouping the years 2016-2019 to compare them with 2020. Rates were calculated per 100.000 inhabitants.Results From 2016 to 2020, a total of 35.050 patients aged ≥ 65 years were hospitalized in Chile with a diagnosis of HF, with the lowest number of admissions in 2020 (6.423). During 2020, annual HF rate was 273.6/100.000, representing a decrease of 18.5% compared to the average annual HF rate of 2016-2019 (335.7/100.000). In 2020, the weekly consultation rate due to trauma in older adults decreased by 20.8% and the weekly hospitalization rate due to trauma in older adults decreased by 18.5%. Conclusion During the COVID-19 pandemic, osteoporotic HF rates decreased, along with ED consultation and hospitalization rates due to trauma in older adults. This could be a result of mobility restrictions and a significant increase in the proportion of self-reliant older adults in the Chilean population.

Fractura de cadera durante el primer año de pandemia en Chile

“…The present study demonstrates a 13% reduction in patients over 60 years of age, consistent with what was reported by Ormeño et al who studied the impact on patients over 65 in our country, reporting an 18% decrease. 13 On the other hand, this is different from what was reported in the United Kingdom and Spain, 9,10 where the incidence did not vary and was significantly greater than the 3% decrease reported in Brazil. 11 In our study, we demonstrated a direct and significant correlation with the country's mobility, which raises the question of whether the incidence of fractures really decreased due to confinement -lower accident rates -or whether there was a significant number of patients who were not hospitalized due to the saturation of the healthcare system or due to the fear of patients and their families to go to the hospital in the context of a pandemic.…”

“…The present study demonstrates a 13% reduction in patients over 60 years of age, consistent with what was reported by Ormeño et al who studied the impact on patients over 65 in our country, reporting an 18% decrease. 13 On the other hand, this is different from what was reported in the United Kingdom and Spain, 9 10 where the incidence did not vary and was significantly greater than the 3% decrease reported in Brazil. 11…”

“…En el presente estudio se demuestra una reducción del 13% en pacientes mayores de 60 años, concordante con lo reportado por Ormeño et al quienes estudiaron el impacto en pacientes sobre 65 en nuestro país, reportando un 18% de disminución. 13 Por otra parte, esto es distinto a lo reportado en Reino Unido y España 9 10 donde la incidencia no vario y significativamente mayor al 3% de disminución reportada en Brasil. 11 En nuestro estudio demostramos una correlación directa y significativa con la movilidad del país, lo que hace cuestionar si realmente la incidencia de fractura disminuyó debido al confinamiento -menor accidentabilidad- o hubo un importante número de pacientes que no fueron hospitalizados por la saturación del sistema de salud o por el miedo de los pacientes y sus familiares de consultar en el contexto de una pandemia.…”

Impact of COVID-19 Pandemic on Fragility Fractures of the Hip: An Interrupted Time-Series Analysis of the Lockdown Periods in Western Greece and Review of the Literature

“…Second, discharge summaries are produced by coding specialists, making them vulnerable to errors such as missing data and digitization errors. Finally, the database used in this study did not specify the origin of hip fractures, whether they were secondary to high-energy trauma or low-energy trauma, which we attempted to mitigate by introducing a lower age threshold of 65 years in accordance with the literature [ 57 ].…”

Impact of the COVID-19 pandemic on osteoporotic hip fractures among outpatients in Germany

“…Ormeño and colleagues presented interesting findings on the impact of the COVID-19 pandemic on osteoporotic hip fractures in Chile. In their study, annual hip fracture rate was 273.6/100,000 in 2020 compared to 335.7/100,000, representing a decrease of 18.5% [ 1 ]. The authors explained that this decrease could be due to social distancing and confinement measures, as a result of which whole families were able to stay at home, which may in turn have had a protective effect against falls.…”