The Library
Impact of COVID-19 on clinical outcomes for patients with fractured hip
Tools
Tools
Tools
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
|
PDF
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 | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RD Surgery |
||||||
| 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 |
||||||
| 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: |
|
||||||
| 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: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
 |
View Item |
Downloads
Downloads per month over past year
