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Impact of COVID-19 on clinical outcomes for patients with fractured hip
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Rasidovic, Damir, Ahmed, Imran, Thomas, Christopher M., Kimani, Peter K., Wall, Peter D. H. and Mangat, Karanjit (2020) Impact of COVID-19 on clinical outcomes for patients with fractured hip. Bone & Joint Open, 1 (11). pp. 697-705. doi:10.1302/2633-1462.111.BJO-2020-0132.R1
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WRAP-Impact-COVID-19-clinical-outcomes-patients-fractured-hip-Kimani-2020.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (674Kb) | Preview |
Official URL: http://dx.doi.org/10.1302/2633-1462.111.BJO-2020-0...
Abstract
Aims:
There are reports of a marked increase in perioperative mortality in patients admitted to hospital with a fractured hip during the COVID-19 pandemic in the UK, USA, Spain, and Italy. Our study aims to describe the risk of mortality among patients with a fractured neck of femur in England during the early stages of the COVID-19 pandemic.
Methods:
We completed a multicentre cohort study across ten hospitals in England. Data were collected from 1 March 2020 to 6 April 2020, during which period the World Health Organization (WHO) declared COVID-19 to be a pandemic. Patients ≥ 60 years of age admitted with hip fracture and a minimum follow-up of 30 days were included for analysis. Primary outcome of interest was mortality at 30 days post-surgery or postadmission in nonoperative patients. Secondary outcomes included length of hospital stay and discharge destination.
Results:
In total, 404 patients were included for final analysis with a COVID-19 diagnosis being made in 114 (28.2%) patients. Overall, 30-day mortality stood at 14.4% (n = 58). The COVID-19 cohort experienced a mortality rate of 32.5% (37/114) compared to 7.2% (21/290) in the non-COVID cohort (p < 0.001). In adjusted analysis, 30-day mortality was greatest in patients who were confirmed to have COVID-19 (odds ratio (OR) 5.64, 95% confidence interval (CI) 2.95 to 10.80; p < 0.001) with an adjusted excess risk of 20%, male sex (OR 2.69, 95% CI 1.37 to 5.29; p = 0.004) and in patients with ≥ two comorbidities (OR 4.68, CI 1.5 to 14.61; p = 0.008). Length of stay was also extended in the COVID-19 cohort, on average spending 17.6 days as an inpatient versus 12.04 days in the non-COVID-19 group (p < 0.001).
Conclusion:
This study demonstrates that patients who sustain a neck of femur fracture in combination with COVID-19 diagnosis have a significantly higher risk of mortality than would be normally expected.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RD Surgery |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | COVID-19 (Disease), Hip joint -- Fractures, Hip joint -- Fractures -- Patients , Hip joint -- Fractures -- Patients -- Treatment | ||||||
| Journal or Publication Title: | Bone & Joint Open | ||||||
| Publisher: | British Editorial Society of Bone and Joint Surgery | ||||||
| ISSN: | 2633-1462 | ||||||
| Official Date: | 4 November 2020 | ||||||
| Dates: |
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| Date of first compliant deposit: | 16 November 2020 | ||||||
| Volume: | 1 | ||||||
| Number: | 11 | ||||||
| Page Range: | pp. 697-705 | ||||||
| DOI: | 10.1302/2633-1462.111.BJO-2020-0132.R1 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| Contributors: |
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