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The effect of the COVID-19 lockdown on the epidemiology of hip fractures in the elderly: a multicentre cohort study.
Malik-Tabassum, K; Robertson, A; Tadros, B J; Chan, G; Crooks, M; Buckle, C; Rogers, B; Selmon, G; Arealis, G.
  • Malik-Tabassum K; East Sussex Healthcare NHS Trust, UK.
  • Robertson A; East Sussex Healthcare NHS Trust, UK.
  • Tadros BJ; East Kent Hospitals University NHS Foundation Trust, UK.
  • Chan G; Western Sussex Hospitals NHS Trust, UK.
  • Crooks M; Brighton and Sussex Medical School, UK.
  • Buckle C; East Sussex Healthcare NHS Trust, UK.
  • Rogers B; Brighton and Sussex University Hospitals NHS Trust, UK.
  • Selmon G; Brighton and Sussex University Hospitals NHS Trust, UK.
  • Arealis G; East Sussex Healthcare NHS Trust, UK.
Ann R Coll Surg Engl ; 103(5): 337-344, 2021 May.
Article in English | MEDLINE | ID: covidwho-1133654
ABSTRACT

INTRODUCTION:

The COVID-19 pandemic presented extraordinary challenges to the UK healthcare system. This study aimed to assess the impact of the COVID-19 lockdown on the epidemiology, treatment pathways and 30-day mortality rates of hip fractures. Outcomes of COVID-19 positive patients were compared against those who tested negative.

METHODS:

An observational, retrospective, multicentre study was conducted across six hospitals in the South East of England. Data were retrieved from the National Hip Fracture Database and electronic medical records. Data was collected for the strictest UK lockdown period (period B=23 March 2020-11 May 2020), and the corresponding period in 2019 (period A).

RESULTS:

A total of 386 patients were admitted during period A, whereas 381 were admitted during period B. Despite the suspension of the 'Best Practice Tariff' during period B, time to surgery, time to orthogeriatric assessment, and 30-day mortality were similar between period A and B. The length of inpatient stay was significantly shorter during period B (11.5 days vs 17.0 days, p<0.001). Comparison of COVID-19 positive and negative patients during period B demonstrated that a positive test was associated with a significantly higher rate of 30-day mortality (53.6% vs 6.7%), surgical delay >36h (46.4% vs 30.8%, p=0.049), and increased length of inpatient stay (15.8 vs 11.7 days, p=0.015).

CONCLUSIONS:

The COVID-19 lockdown did not alter the epidemiology of hip fractures. A substantially higher mortality rate was observed among patients with a COVID-19 positive test. These findings should be taken into consideration by the healthcare policymakers while formulating contingency plans for a potential 'second wave'.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Public Policy / Communicable Disease Control / Mortality / Time-to-Treatment / COVID-19 / Hip Fractures / Length of Stay Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7071

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Public Policy / Communicable Disease Control / Mortality / Time-to-Treatment / COVID-19 / Hip Fractures / Length of Stay Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7071