The Evolving COVID-19 Effect on Hip Fracture Patients

Hadfield, James; Gray, Andrew

doi:10.1016/j.injury.2020.06.006

Cited by 32 publications

(42 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study conducted by Spanish researchers indicates, respectively, that the total mortality rate was 30.4% for COVID-19 positive patients and 10.3% for patients without coronavirus. 20 Similar results were obtained by Kumar et al, Maniscalco et al and Hadfield et al 15 , 16 , 21 , 22 They indicate an increase in mortality rate of people tested positive for the presence of COVID-19 virus, with proximal femur fracture or hip fracture.…”

Section: Resultssupporting

confidence: 73%

“…In the literature analyzed for the purpose of this study, attention was also paid to the treatment algorithms during the COVID-19 pandemic. 15 , 16 , 21 , 23 - 25 Study was conducted in order to compare the management and 30-day outcomes of hip fracture patients admitted during the COVID-19 outbreak with the pre-pandemic period. Three periods have been analyzed: period “A” from 23/03/2018 to 11/05/2018, period “B” from 23/03/2019 to 11/05/2019 and period “C” from 23/03/2020 to 11/05/2020.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Falls as One of the Atypical Presentations of COVID-19 in Older Population

Gawrońska

Lorkowski

2021

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

Introduction: Studies revealed COVID-19 atypical symptoms such as falls, delirium, confusion, dizziness, unusual fatigue in older patients. Falls in the older population and their consequences are one of the leading causes of disability; they significantly reduce the quality of life and lead to loss of independence and impaired social functioning. The aim of this study is to present the possible correlation between COVID-19 and diseases of the musculoskeletal system, in particular the occurrence of fall-related injuries. Significance: This article highlights the importance of falls as one of the atypical symptoms of COVID-19 infection in older adults, which is not directly associated with infection and could be misinterpreted. Methods: The conducted meta-analysis is based on a review of the scientific literature available in English, French, Dutch, Polish in the PubMed/MEDLINE, Cochrane Library, Embase, Scopus, PEDro, GBL databases from December 1, 2019 to July 30, 2020, covering Clinical Trial, Randomized Controlled Trial, Meta-Analysis, Systematic Reviews and Case Reports. The following keywords were taken into account: fall, (hip/pertrochanteric/proximal femur) fracture, aged and COVID-19. Twenty-seven references were accepted for final analysis. Results: It was found that symptoms such as falls observed in the older adults can be associated with COVID-19 infection. Falls and slips are also the most common mechanism for hip fracture during the pandemic outbreak. Conclusions: According to authors of this study, atypical presentations of COVID-19 should be considered when screening and testing the people at increased risk due to their age. However, further prospective studies are urgently needed to investigate the possible correlation between COVID-19 and falls in older adults.

show abstract

Section: Resultssupporting

confidence: 73%

Section: Resultsmentioning

confidence: 99%

Falls as One of the Atypical Presentations of COVID-19 in Older Population

Gawrońska

Lorkowski

2021

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

show abstract

“…Several studies have reported an increased mortality rate among patients with hip fractures who were diagnosed with COVID-19 [3,11,16,24,[27][28][29][30][31]. In this study none of the con rmed or suspected COVID-19 patients died in-hospital so the COVID-19 diagnosis may not be driving this increased risk for mortality.…”

Section: Discussionmentioning

confidence: 59%

Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic 

Jarvis¹,

Salottolo²,

Madayag

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Concerns of contracting the highly contagious disease COVID-19 have led to a reluctance in seeking medical attention, which may contribute to delayed hospital arrival among traumatic patients. The study objective was to describe differences in time from injury to arrival for patients with traumatic hip fractures admitted during the pandemic to pre-pandemic patients. Materials and Methods: This retrospective cohort study at six level I trauma centers included patients with traumatic hip fractures. Patients with a non-fall mechanism and those who were transferred in were excluded. Patients admitted 3/16/2019-6/30/2019 were in the “pre-pandemic” group, patients were admitted 3/16/2020-6/30/2020 were in the “pandemic” group. The primary outcome was time from injury to arrival. Secondary outcomes were time from arrival to surgical intervention, hospital length of stay (HLOS), and mortality. Results: There were 703 patients, 352 (50.1%) pre-pandemic and 351 (49.9%) during the pandemic. Overall, 66.5% were female and the median age was 82 years old. Patients were similar in age, race, gender, and injury severity score. The median time from injury to hospital arrival was statistically shorter for pre-pandemic patients when compared to pandemic patients, 79.5 (56, 194.5) minutes vs. 91 (59, 420), p=0.04. The time from arrival to surgical intervention (p=0.64) was statistically similar between groups. For both groups, the median HLOS was 5 days, p=0.45. In-hospital mortality was significantly higher during the pandemic, 1.1% vs 3.4%, p=0.04.Conclusions: While time from injury to hospital arrival was statistically longer during the pandemic, the difference may not be clinically important. Time from arrival to surgical intervention remained similar, despite changes made to prevent COVID-19 transmission. Physicians should anticipate a slightly delayed arrival for hip fractures and provide prompt evaluation to reach definitive care in a timely manner.

show abstract

“…RJAH has adapted to deliver care for trauma patients during COVID-19 pandemic including the cessation of elective operating, similar to other orthopaedic centres in order to help resource management and continued emergency care. 7 – 10 The clinical environments were categorized as green (low-risk for COVID-19) and a blue (high-risk COVID-19) areas, similar to the proposed pathways described by the BOA for recommencement of non-urgent care. 11 Patients received a risk assessment for COVID-19 exposure in RSH, based on a simple risk of exposure questionnaire such that high risk or positive patients who remained medically stable were managed in a separate blue ward within RJAH.…”

Section: Methodsmentioning

confidence: 99%

Effect of COVID-19 on a rural orthopaedic hip fracture service

et al. 2020

View full text Add to dashboard Cite

Aims Our rural orthopaedic service has undergone service restructure during the COVID-19 pandemic in order to sustain hip fracture care. All adult trauma care has been centralised to the Royal Shrewsbury Hospital for assessment and medical input, before transferring those requiring operative intervention to the Robert Jones and Agnes Hunt Orthopaedic Hospital. We aim to review the impact of COVID-19 on hip fracture workload and service changes upon management of hip fractures. Methods We reviewed our prospectively maintained trust database and National Hip Fracture Database records for the months of March and April between the years 2016 and 2020. Our assessment included fracture pattern (intrascapular vs extracapsular hip fracture), treatment intervention, length of stay and mortality. Results We treated 288 patients during March and April between 2016 and 2020, with a breakdown of 55, 58, 53, 68, and 54 from 2016 to 2020 respectively. Fracture pattern distribution in the pre-COVID-19 years of 2016 to 2019 was 58% intracapsular and 42% extracapsular. In 2020 (COVID-19 period) the fracture patterns were 65% intracapsular and 35% extracapsular. Our mean length of stay was 13.1 days (SD 8.2) between 2016 to 2019, and 5.0 days (6.3) days in 2020 (p < 0.001). Between 2016 and 2019 we had three deaths in hip fracture patients, and one death in 2020. Hemiarthroplasty and dynamic hip screw fixation have been the mainstay of operative intervention across the five years and this has continued in the COVID-19 period. We have experienced a rise in conservatively managed patients; ten in 2020 compared to 14 over the previous four years. Conclusion There has not been a reduction in the number of hip fractures during COVID-19 period compared to the same time period over previous years. In our experience, there has been an increase in conservative treatment and decreased length of stay during the COVID -19 period. Cite this article: Bone Joint Open 2020;1-8:500–507.

show abstract

The Evolving COVID-19 Effect on Hip Fracture Patients

Cited by 32 publications

References 2 publications

Falls as One of the Atypical Presentations of COVID-19 in Older Population

Falls as One of the Atypical Presentations of COVID-19 in Older Population

Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic

Effect of COVID-19 on a rural orthopaedic hip fracture service

Contact Info

Product

Resources

About

The Evolving COVID-19 Effect on Hip Fracture Patients

Cited by 32 publications

References 2 publications

Falls as One of the Atypical Presentations of COVID-19 in Older Population

Falls as One of the Atypical Presentations of COVID-19 in Older Population

Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic&nbsp;

Effect of COVID-19 on a rural orthopaedic hip fracture service

Contact Info

Product

Resources

About

Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic