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

Anusitviwat, Chirathit; Vanitcharoenkul, Ekasame; Chotiyarnwong, Pojchong; Unnanuntana, Aasis

doi:10.1007/s00198-022-06485-w

Cited by 5 publications

(4 citation statements)

References 46 publications

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“…A multidisciplinary care team assessed all patients with an FHF and treated them according to our center’s hip fracture protocol [ 9 ]. After the treatment, video-based osteoporosis education and supplementary reading material were provided to the patients and their caregivers.…”

Section: Methodsmentioning

confidence: 99%

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Three-year outcomes of a fracture liaison service model at a university-based tertiary care hospital in Thailand

et al. 2023

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Summary Fragility hip fracture (FHF) is a serious complication of osteoporosis. A fracture liaison service (FLS) is crucial in preventing FHF. Our retrospective data of 489 patients with FHF and 3-year follow-ups demonstrated that the FLS improved functional outcomes. Our study’s mortality rates were lower than in other published series. Purpose This study assessed the 3-year outcomes after fragility hip fracture (FHF) treatment by a multidisciplinary team from the Siriraj Fracture Liaison Service (Si–FLS). The review investigated the administration rates of anti-osteoporosis medication, refracture, and mortality; activities of daily living; mobility; and health-related quality of life. Methods A retrospective review was performed of the records of Si-FLS patients given FHF treatment between June 2016 and October 2018. The outcomes were evaluated at 3 time points: before discharge, and 1 and 3 years after treatment. Results The study enrolled 489 patients (average age, 78). The mortality and refracture rates at 1 year after hip fracture were 13.9% and 1.6%, respectively. At the 3-year follow-up, both rates were higher (20.4% and 5.7%, respectively). The Barthel Index and EuroQoL Visual Analogue Scale had risen to a plateau at the 1-year follow-up and remained stable to the 3-year follow-up. One year after treatment, approximately 60% of the patients could ambulate outdoors, and the proportion remained steady until the 3-year follow-up. There was no difference in the 1- and 3-year follow-up anti-osteoporosis medication administration rates (approximately 40%). Conclusions This study confirms the benefits of having a multidisciplinary FLS care team to manage older people with FHF. An FLS improves the care of patients with FHF and the social support of caregivers and relatives. The FLS maintained the functional outcomes of the patients through 3 years of postfracture treatment.

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Section: Methodsmentioning

confidence: 99%

“…Patients mark an “X” on the scale in the position that reflects their perception of their current health status. This tool has been validated in older adults with FHFs [ 9 , 14 ].…”

Section: Methodsmentioning

confidence: 99%

Three-year outcomes of a fracture liaison service model at a university-based tertiary care hospital in Thailand

et al. 2023

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“…They also explained that this parameter did not statistically affect the inhospital complications among patients with fragility hip fractures. (14) According to Jarvis et al, during the COVID-19 period, young patients tended to move faster from arrival to surgery because elective surgical cases were postponed and the operating rooms were reserved for urgent and emergency cases. (15) This was not true for geriatric patients who needed more time for assessment and pre-operative management before surgery.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Covid-19 Pandemic on Fragility Hip Fracture Management and Mortality Rate

Rattanakitkoson

Chinvattanachot

Piyapromdee

2023

J Southeast Asian Med Res

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Background: The COVID-19 pandemic has greatly affected patients without COVID, including osteoporotic hip fractures. Treatment protocols and time for surgery have been disrupted and delayed resulting in unsatisfactory outcomes. This study compared the mortality rate among patients with osteoporotic hip fractures during the COVID-19 pandemic and during the prepandemic periods. Methods: The patients’ information recorded in the Fracture Liaison Service (FLS) registry was retrospectively reviewed. We defined the prepandemic group as the admissions between May 2019 and March 2020 and the pandemic group as admissions from April 2020 to February 2021. The demographic data were collected, including serum calcium and 25(OH)D levels. Time to surgery, postoperative complications, length of stay and death were obtained and compared between the two periods. Results: We included 813 patients, with 444 and 369 patients in the prepandemic and the pandemic groups, respectively. Mean age, sex and comorbidities were comparable in both groups. The proportion of patients with insufficient and deficient vitamin D was significantly higher in the pandemic group (46.41 vs. 62.85%, p<0.01). Time to surgery and length of hospital stay was significantly longer in the pandemic period (p <0.05). The mortality was higher but did not significantly differ in the pandemic period with an adjusted hazard ratio of 1.08 (95% CI = 0.76-1.54). Conclusion: Properly managing hip fractures during the pandemic is crucial to prevent and reduce morbidity and mortality. Inadequate serum vitamin D level has been noted in the pandemic group but was not associated with mortality rate.

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“…These environmental changes would have impacted elderly hospitalized patients and their family members in many ways. In a study on postoperative exercise recovery in elderly patients with hip fracture during the pandemic, Anusitviwat et al 23) reported that recovery of motor ability decreased and complications increased over a period of three months after surgery compared to the pre-pandemic.…”

Section: Discussionmentioning

confidence: 99%

The Effects of COVID-19 Pandemic on the Recovery of Hip Fracture Patients

Chung,

Baek,

Park

et al. 2023

Hip & Pelvis

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Purpose To figure out how complete control of family visits to prevent infection of coronavirus disease 2019 (COVID-19) affected the activity recovery of hip fracture patients admitted to nursing hospitals. Materials and Methods Eighty-one patients with hip surgery in the two years prior to COVID-19 pandemic were classified as Group A, and 103 patients in the next two years were designated as Group B. The subjects’ walking ability was evaluated by using the modified Koval index (MKI). In order to analyze the impact of the family visit control to the subjects, each group was classified into two different groups: (1) inpatients group who admitted to nursing hospitals and (2) home-treated patients. Additionally, statistical elements were processed in consideration of other factors that may affect the results of the experiment. Results The MKI evaluated at 6 months postoperative was 3.31±1.79 in Group A and 2.77±1.91 in Group B, and it was meaningfully low after the pandemic ( P =0.04). There was significantly low among both of Group A 2.74±1.76 and Group B 1.93±1.81 after the pandemic ( P =0.03) among those treated at the nursing hospital. The rate of deterioration of the MKI was 35 (43.2%) in Group A and 57 (55.3%) in Group B, which increased by 12.1% after the pandemic. Conclusion The pandemic had a negative effect on the recovery of postoperative activities of elderly hip fracture patients who admitted to nursing hospitals when family access was completely restricted to prevent infection.

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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

Cited by 5 publications

References 46 publications

Three-year outcomes of a fracture liaison service model at a university-based tertiary care hospital in Thailand

Three-year outcomes of a fracture liaison service model at a university-based tertiary care hospital in Thailand

Impact of the Covid-19 Pandemic on Fragility Hip Fracture Management and Mortality Rate

The Effects of COVID-19 Pandemic on the Recovery of Hip Fracture Patients

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