The Effects of COVID‐19 on Geriatric Hip Fracture Management and 1‐Year Mortality in Beijing

Abstract

Objectives Concerns about the coronavirus disease 2019 (COVID‐19) pandemic resulted in unprecedented challenges to the management of geriatric hip fractures. We aimed to evaluate the effects of the COVID‐19 surge on the time to surgery and 1 year mortality in geriatric patients with hip fracture at a large, urban Level 1 trauma center in Beijing, and to guide the management of geriatric hip fracture patients throughout the COVID‐19 pandemic. Methods This single‐center retrospective study included consecutive patients aged ≥65 years and injured 3 weeks prior to admission. Demographic and surgical data were collected between January 20 and May 31, 2020, and from the same period in 2019. Mortality data and functional status were collected at follow‐up of 1‐year after surgery. The primary outcomes were time to surgery and 1 year mortality. Results There were no significant differences in sex, fracture type, and surgical pattern between the 2020 (n = 261) and 2019 time‐matched (n = 307) cohorts. The time from admission to surgery was significantly delayed in the 2020 cohort compared with that in the 2019 cohort (48.9 h vs 20.5 h, p < 0.001). Fewer patients underwent surgery within 48 h in the 2020 cohort (65.5% vs 87.6%, p < 0.001). Surgical delay was also associated with an increased risk of inpatient complications (30.2% vs 20.8%, p = 0.010), however there was no significant difference in the 1‐year mortality rate, nor between pre‐injury and 1 year follow‐up mobility as assessed by Parker score. Only approximately half of the patients in both groups completely returned to their pre‐injury mobility levels. Conclusions The COVID‐19 pandemic has significantly increased the surgery waiting time for geriatric patients with hip fractures, which resulted in increased inpatient complications without a higher mortality rate within 1 year. This reinforces the importance of maintaining timely and protocolized care for geriatric hip fractures throughout any subsequent waves of the pandemic.

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

“…[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. Furthermore, the authors reported that there was no difference in time to surgery, length of hospital stay, major complications, and respiratory complications between the two periods.…”

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

“…Higher mortality rates and serious complications resulting from infection have been reported, particularly among older patients with hip fracture, for which a large number of complications and a high mortality rate have been reported 9 10 11 12) . Although older patients must undergo surgery for treatment of fracture injuries as soon as possible, according to some reports, hospitalization and surgery were sometimes delayed in the early stage of the pandemic, increasing the hospitalization period and aggravating mortality 13 14) . However, it was also reported that acceptable results were achieved with prompt surgical treatment of patients with hip fracture without increasing complications even during the pandemic period 15) .…”

Bilateral insufficiency fracture of coracoid process: A rare case report

“…The Harris score of left hip was 10. 5 The patient wanted hip surgery to relieve left hip pain. Therefore, on 26 December 2020, CT scan was used to evaluate the condition of the lungs before hip surgery, and it showed no coracoid process fracture ( Figure 3 ).…”