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Thirty-day mortality following surgical management of hip fractures during the COVID-19 pandemic: findings from a prospective multi-centre UK study.
Narang, A; Chan, G; Aframian, A; Ali, Z; Carr, A; Goodier, H; Morgan, C; Park, C; Sugand, K; Walton, T; Wilson, M; Belgaumkar, A; Gallagher, K; Ghosh, K; Gibbons, C; Keightley, A; Nawaz, Z; Wakeling, C; Sarraf, K; Rogers, B A; Kieffer, W K M.
  • Narang A; Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Canada Avenue, Redhill, Surrey, RH1 5RH, UK.
  • Chan G; Western Sussex Hospitals NHS Foundation Trust, Chichester, UK.
  • Aframian A; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
  • Ali Z; Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Canada Avenue, Redhill, Surrey, RH1 5RH, UK.
  • Carr A; Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Canada Avenue, Redhill, Surrey, RH1 5RH, UK.
  • Goodier H; Poole General Hospital & the Royal Bournemouth Hospital, Poole, UK.
  • Morgan C; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
  • Park C; St Mary's Hospital, London, London, UK.
  • Sugand K; St Mary's Hospital, London, London, UK.
  • Walton T; Brighton and Sussex University Hospitals, Brighton, UK.
  • Wilson M; Poole General Hospital & the Royal Bournemouth Hospital, Poole, UK.
  • Belgaumkar A; Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Canada Avenue, Redhill, Surrey, RH1 5RH, UK.
  • Gallagher K; Poole General Hospital & the Royal Bournemouth Hospital, Poole, UK.
  • Ghosh K; Western Sussex Hospitals NHS Foundation Trust, Chichester, UK.
  • Gibbons C; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
  • Keightley A; Royal Surrey Hospital NHS Foundation Trust, Guildford, UK.
  • Nawaz Z; Frimley Park Hospital, Camberley, UK.
  • Wakeling C; Western Sussex Hospitals NHS Foundation Trust, Chichester, UK.
  • Sarraf K; St Mary's Hospital, London, London, UK.
  • Rogers BA; Brighton and Sussex University Hospitals, Brighton, UK.
  • Kieffer WKM; Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Canada Avenue, Redhill, Surrey, RH1 5RH, UK. will.kieffer@nhs.net.
Int Orthop ; 45(1): 23-31, 2021 01.
Article in English | MEDLINE | ID: covidwho-734827
ABSTRACT

PURPOSE:

Thirty-day mortality of patients with hip fracture is well researched and predictive; validated scoring tools have been developed (Nottingham Hip Fracture Score, NHFS). COVID-19 has significantly greater mortality in the elderly and comorbid patients which includes hip fracture patients. Non-operative treatment is not appropriate due to significantly higher mortality, and therefore, these patients are often exposed to COVID-19 in the peri-operative period. What is unclear is the effect of concomitant COVID-19 infection in these patients.

METHODS:

A multicentre prospective study across ten sites in the United Kingdom (responsible for 7% of hip fracture patients per annum in the UK). Demographic and background information were collected by independent chart review. Data on surgical factors included American Society of Anesthesiologists (ASA) score, time to theatre, Nottingham Hip fracture score (NHFS) and classification of fracture were also collected between 1st March 2020 and 30th April 2020 with a matched cohort from the same period in 2019.

RESULTS:

Actual and expected 30-day mortality was found to be significantly higher than expected for 2020 COVID-19 positive patients (RR 3.00 95% CI 1.57-5.75, p < 0.001), with 30 observed deaths compared against the 10 expected from NHFS risk stratification.

CONCLUSION:

COVID-19 infection appears to be an independent risk factor for increased mortality in hip fracture patients. Whilst non-operative management of these fractures is not suggested due to the documented increased risks and mortality, this study provides evidence to the emerging literature of the severity of COVID-19 infection in surgical patients and the potential impact of COVID-19 on elective surgical patients in the peri-operative period.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hip Fractures Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Int Orthop Year: 2021 Document Type: Article Affiliation country: S00264-020-04739-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hip Fractures Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Int Orthop Year: 2021 Document Type: Article Affiliation country: S00264-020-04739-y