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Delayed hospital admission for traumatic hip fractures during the COVID-19 pandemic.
Jarvis, Stephanie; Salottolo, Kristin; Madayag, Robert; Pekarek, Jennifer; Nwafo, Nnamdi; Wessel, Alexander; Duane, Therese; Roberts, Zachary; Lieser, Mark; Corrigan, Chad; Bar-Or, David.
  • Jarvis S; ION Research, 501 East Hampden Avenue, Englewood, Colorado, 80113, USA.
  • Salottolo K; ION Research, 501 East Hampden Avenue, Englewood, Colorado, 80113, USA.
  • Madayag R; St. Anthony Hospital, Lakewood, CO, USA.
  • Pekarek J; ION Research, 501 East Hampden Avenue, Englewood, Colorado, 80113, USA.
  • Nwafo N; St. Anthony Hospital, Lakewood, CO, USA.
  • Wessel A; Swedish Medical Center, Englewood, CO, USA.
  • Duane T; Penrose Hospital, Colorado Springs, CO, USA.
  • Roberts Z; Medical City Plano, Plano, TX, USA.
  • Lieser M; Research Medical Center, Kansas City, MO, USA.
  • Corrigan C; Research Medical Center, Kansas City, MO, USA.
  • Bar-Or D; Wesley Medical Center, Wichita, KS, USA.
J Orthop Surg Res ; 16(1): 237, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1166922
ABSTRACT

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 16 March 2019-30 June 2019 were in the "pre-pandemic" group, patients were admitted 16 March 2020-30 June 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) min 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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Time-to-Treatment / COVID-19 / Hip Fractures Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Orthop Surg Res Year: 2021 Document Type: Article Affiliation country: S13018-021-02382-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Time-to-Treatment / COVID-19 / Hip Fractures Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Orthop Surg Res Year: 2021 Document Type: Article Affiliation country: S13018-021-02382-w