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1. IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic

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Hall, A, Clement, N, Ojeda-Thies, C, Maclullich, A, Toro, G, Johansen, A, White, T, Duckworth, A, Abdul-Jabar, H, Abu-Rajab, R, Abugarja, A, Adam, K, Aguado Hernández, H, Améstica Lazcano, G, Anderson, S, Ansar, M, Antrobus, J, Aragón Achig, E, Archunan, M, Arrieta Salinas, M, Ashford-Wilson, S, Assens Gibert, C, Athanasopoulou, K, Awadelkarim, M, Baird, S, Bajada, S, Balakrishnan, S, Balasubramanian, S, Ballantyne, J, Bárcena Goitiandia, L, Barkham, B, Barmpagianni, C, Barres-Carsi, M, Barrett, S, Baskaran, D, Bell, J, Bell, K, Bell, S, Bellelli, G, Benchimol, J, Boietti, B, Boswell, S, Braile, A, Brennan, C, Brent, L, Brooke, B, Bruno, G, Burahee, A, Burns, S, Calabrò, G, Campbell, L, Carabelli, G, Carnegie, C, Carretero Cristobal, G, Caruana, E, Cassinello Ogea, M, Castellanos Robles, J, Castillon, P, Chakrabarti, A, Cecere, A, Chen, P, Clarke, J, Collins, G, Corrales Cardenal, J, Corsi, M, Cózar Adelantado, G, Craxford, S, Crooks, M, Cuarental-García, J, Cuthbert, R, Dall, G, Daskalakis, I, De Cicco, A, Diana, D, Demaria, P, Dereix, J, Díaz Jiménez, J, Dinamarca Montecinos, J, Do Le, H, Donoso Coppa, J, Drosos, G, Duffy, A, East, J, Eastwood, D, Elbahari, H, Elias de Molins Peña, C, Elmamoun, M, Emmerson, B, Escobar Sánchez, D, Faimali, M, Farré-Mercadé, M, Farrow, L, Fayez, A, Fell, A, Fenner, C, Ferguson, D, Finlayson, L, Flores Gómez, A, Freeman, N, French, J, Gabardo Calvo, S, Gagliardo, N, Garcia Albiñana, J, García Cruz, G, García de Cortázar Antolín, U, García Virto, V, Gealy, S, Gil Caballero, S, Gill, M, González González, M, Gopireddy, R, Guntley, D, Gurung, B, Guzmán Rosales, G, Haddad, N, Hafeez, M, Haller, P, Halligan, E, Hardie, J, Hawker, I, Helal, A, Herrera Cruz, M, Herreros Ruiz-Valdepeñas, R, Horton, J, Howells, S, Howieson, A, Hughes, L, Hünicken Torrez, F, Hurtado Ortega, A, Huxley, P, Hamid, H, Ilahi, N, Iliadis, A, Inman, D, Jadhao, P, Jandoo, R, Jawad, L, Jayatilaka, M, Jenkins, P, Jeyapalan, R, Johnson, D, Johnston, A, Joseph, S, Kapoor, S, Karagiannidis, G, Karanam, K, Kattakayam, F, Konarski, A, Kontakis, G, Labrador Hernández, G, Lancaster, V, Landi, G, Le, B, Liew, I, Logishetty, K, Lopez Marquez, A, Lopez, J, Lum, J, Macpherson, G, Madan, S, Mahroof, S, Malik-Tabassum, K, Mallina, R, Maqsood, A, Marson, B, Martin Legorburo, M, Martin-Perez, E, Martínez Jiménez, T, Martinez Martin, J, Mayne, A, Mayor, A, Mcalinden, G, Mclean, L, Mcdonald, L, Mcintyre, J, Mckay, P, Mckean, G, Mcshane, H, Medici, A, Meeke, C, Meldrum, E, Mendez, M, Mercer, S, Merino Perez, J, Mesa-Lampré, M, Mighton, S, Milne, K, Mohamed Yaseen, M, Moppett, I, Mora, J, Morales-Zumel, S, Moreno Fenoll, I, Mousa, A, Murray, A, Murray, E, Nair, R, Neary, F, Negri, G, Negus, O, Newham-Harvey, F, Ng, N, Nightingale, J, Noor Mohamed Anver, S, Nunag, P, O'Hare, M, Ollivere, B, Ortés Gómez, R, Owens, A, Page, S, Palloni, V, Panagiotopoulos, A, Panagiotopoulos, E, Panesar, P, Papadopoulos, A, Spyridon, P, Pareja Sierra, T, Park, C, Parwaiz, H, Paterson-Byrne, P, Patton, S, Pearce, J, Porter, M, Pellegrino, A, Pèrez Cuellar, A, Pezzella, R, Phadnis, A, Pinder, C, Piper, D, Powell-Bowns, M, Prieto Martín, R, Probert, A, Ramesh, A, Ramírez de Arellano, M, Renton, D, Rickman, S, Robertson, A, Roche Albero, A, Rodrigo Verguizas, J, Rodríguez Couso, M, Rooney, J, Sáez-López, P, Saldaña-Díaz, A, Santulli, A, Sanz Pérez, M, Sarraf, K, Scarsbrook, C, Scott, C, Scott, J, Shah, S, Sharaf, S, Sharma, S, Shirley, D, Siano, A, Simpson, J, Singh, A, Sinnett, T, Sisodia, G, Smith, P, Sophena Bert, E, Steel, M, Stewart, A, Stewart, C, Sugand, K, Sullivan, N, Sweeting, L, Symes, M, Tan, D, Tancredi, F, Tatani, I, Thomas, P, Thomson, F, Toner, N, Tong, A, Toro, A, Tosounidis, T, Tottas, S, Trinidad Leo, A, Tucker, D, Vemulapalli, K, Ventura Garces, D, Vernon, O, Viveros Garcia, J, Ward, A, Ward, K, Watson, K, Weerasuriya, T, Wickramanayake, U, Wilkinson, H, Windley, J, Wood, J, Wynell-Mayow, W, Zatti, G, Zeiton, M, Zurrón Lobato, M, Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, MacLullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdus, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioannis, De Cicco, Annalisa, Diana, de la Fuente de Dios, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Luis, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgios, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nicholas, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, James, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexis, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgios, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgios, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatius, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, McAlinden, Gavan, McLean, Lucille, McDonald, Lorna, McIntyre, Joshua, McKay, Pamela, McKean, Greg, McShane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesus, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Jess, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, AnneMarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andreas, Panagiotopoulos, Elias, Panesar, Paul, Papadopoulos, Antonios, Spyridon, Papagiannis, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andres, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, James, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoros, Tottas, Stylianos, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlos, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, Zurrón Lobato, Miriam, Hall, A, Clement, N, Ojeda-Thies, C, Maclullich, A, Toro, G, Johansen, A, White, T, Duckworth, A, Abdul-Jabar, H, Abu-Rajab, R, Abugarja, A, Adam, K, Aguado Hernández, H, Améstica Lazcano, G, Anderson, S, Ansar, M, Antrobus, J, Aragón Achig, E, Archunan, M, Arrieta Salinas, M, Ashford-Wilson, S, Assens Gibert, C, Athanasopoulou, K, Awadelkarim, M, Baird, S, Bajada, S, Balakrishnan, S, Balasubramanian, S, Ballantyne, J, Bárcena Goitiandia, L, Barkham, B, Barmpagianni, C, Barres-Carsi, M, Barrett, S, Baskaran, D, Bell, J, Bell, K, Bell, S, Bellelli, G, Benchimol, J, Boietti, B, Boswell, S, Braile, A, Brennan, C, Brent, L, Brooke, B, Bruno, G, Burahee, A, Burns, S, Calabrò, G, Campbell, L, Carabelli, G, Carnegie, C, Carretero Cristobal, G, Caruana, E, Cassinello Ogea, M, Castellanos Robles, J, Castillon, P, Chakrabarti, A, Cecere, A, Chen, P, Clarke, J, Collins, G, Corrales Cardenal, J, Corsi, M, Cózar Adelantado, G, Craxford, S, Crooks, M, Cuarental-García, J, Cuthbert, R, Dall, G, Daskalakis, I, De Cicco, A, Diana, D, Demaria, P, Dereix, J, Díaz Jiménez, J, Dinamarca Montecinos, J, Do Le, H, Donoso Coppa, J, Drosos, G, Duffy, A, East, J, Eastwood, D, Elbahari, H, Elias de Molins Peña, C, Elmamoun, M, Emmerson, B, Escobar Sánchez, D, Faimali, M, Farré-Mercadé, M, Farrow, L, Fayez, A, Fell, A, Fenner, C, Ferguson, D, Finlayson, L, Flores Gómez, A, Freeman, N, French, J, Gabardo Calvo, S, Gagliardo, N, Garcia Albiñana, J, García Cruz, G, García de Cortázar Antolín, U, García Virto, V, Gealy, S, Gil Caballero, S, Gill, M, González González, M, Gopireddy, R, Guntley, D, Gurung, B, Guzmán Rosales, G, Haddad, N, Hafeez, M, Haller, P, Halligan, E, Hardie, J, Hawker, I, Helal, A, Herrera Cruz, M, Herreros Ruiz-Valdepeñas, R, Horton, J, Howells, S, Howieson, A, Hughes, L, Hünicken Torrez, F, Hurtado Ortega, A, Huxley, P, Hamid, H, Ilahi, N, Iliadis, A, Inman, D, Jadhao, P, Jandoo, R, Jawad, L, Jayatilaka, M, Jenkins, P, Jeyapalan, R, Johnson, D, Johnston, A, Joseph, S, Kapoor, S, Karagiannidis, G, Karanam, K, Kattakayam, F, Konarski, A, Kontakis, G, Labrador Hernández, G, Lancaster, V, Landi, G, Le, B, Liew, I, Logishetty, K, Lopez Marquez, A, Lopez, J, Lum, J, Macpherson, G, Madan, S, Mahroof, S, Malik-Tabassum, K, Mallina, R, Maqsood, A, Marson, B, Martin Legorburo, M, Martin-Perez, E, Martínez Jiménez, T, Martinez Martin, J, Mayne, A, Mayor, A, Mcalinden, G, Mclean, L, Mcdonald, L, Mcintyre, J, Mckay, P, Mckean, G, Mcshane, H, Medici, A, Meeke, C, Meldrum, E, Mendez, M, Mercer, S, Merino Perez, J, Mesa-Lampré, M, Mighton, S, Milne, K, Mohamed Yaseen, M, Moppett, I, Mora, J, Morales-Zumel, S, Moreno Fenoll, I, Mousa, A, Murray, A, Murray, E, Nair, R, Neary, F, Negri, G, Negus, O, Newham-Harvey, F, Ng, N, Nightingale, J, Noor Mohamed Anver, S, Nunag, P, O'Hare, M, Ollivere, B, Ortés Gómez, R, Owens, A, Page, S, Palloni, V, Panagiotopoulos, A, Panagiotopoulos, E, Panesar, P, Papadopoulos, A, Spyridon, P, Pareja Sierra, T, Park, C, Parwaiz, H, Paterson-Byrne, P, Patton, S, Pearce, J, Porter, M, Pellegrino, A, Pèrez Cuellar, A, Pezzella, R, Phadnis, A, Pinder, C, Piper, D, Powell-Bowns, M, Prieto Martín, R, Probert, A, Ramesh, A, Ramírez de Arellano, M, Renton, D, Rickman, S, Robertson, A, Roche Albero, A, Rodrigo Verguizas, J, Rodríguez Couso, M, Rooney, J, Sáez-López, P, Saldaña-Díaz, A, Santulli, A, Sanz Pérez, M, Sarraf, K, Scarsbrook, C, Scott, C, Scott, J, Shah, S, Sharaf, S, Sharma, S, Shirley, D, Siano, A, Simpson, J, Singh, A, Sinnett, T, Sisodia, G, Smith, P, Sophena Bert, E, Steel, M, Stewart, A, Stewart, C, Sugand, K, Sullivan, N, Sweeting, L, Symes, M, Tan, D, Tancredi, F, Tatani, I, Thomas, P, Thomson, F, Toner, N, Tong, A, Toro, A, Tosounidis, T, Tottas, S, Trinidad Leo, A, Tucker, D, Vemulapalli, K, Ventura Garces, D, Vernon, O, Viveros Garcia, J, Ward, A, Ward, K, Watson, K, Weerasuriya, T, Wickramanayake, U, Wilkinson, H, Windley, J, Wood, J, Wynell-Mayow, W, Zatti, G, Zeiton, M, Zurrón Lobato, M, Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, MacLullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdus, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioannis, De Cicco, Annalisa, Diana, de la Fuente de Dios, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Luis, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgios, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nicholas, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, James, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexis, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgios, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgios, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatius, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, McAlinden, Gavan, McLean, Lucille, McDonald, Lorna, McIntyre, Joshua, McKay, Pamela, McKean, Greg, McShane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesus, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Jess, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, AnneMarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andreas, Panagiotopoulos, Elias, Panesar, Paul, Papadopoulos, Antonios, Spyridon, Papagiannis, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andres, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, James, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoros, Tottas, Stylianos, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlos, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, and Zurrón Lobato, Miriam

Abstract

Aims: This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods: A multicentre collaboration among 112 centres in 14 countries collected data on all patients presenting with a hip fracture between 1st March-31st May 2020. Demographics, residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, management, ASA grade, length of stay, COVID-19 and 30-day mortality status were recorded. Results: A total of 7090 patients were included, with a mean age of 82.2 (range 50–104) years and 4959 (69.9%) being female. Of 651 (9.2%) patients diagnosed with COVID-19, 225 (34.6%) were positive at presentation and 426 (65.4%) were positive postoperatively. Positive COVID-19 status was independently associated with male sex (odds ratio (OR) 1.38, p = 0.001), residential care (OR 2.15, p < 0.001), inpatient fall (OR 2.23, p = 0.003), cancer (OR 0.63, p = 0.009), ASA grades 4 (OR 1.59, p = 0.008) or 5 (OR 8.28, p < 0.001), and longer admission (OR 1.06 for each increasing day, p < 0.001). Patients with COVID-19 at any time had a significantly lower chance of 30-day survival versus those without COVID-19 (72.7% versus 92.6%, p < 0.001). COVID-19 was independently associated with an increased 30-day mortality risk (hazard ratio (HR) 2.83, p < 0.001). Increasing age (HR 1.03, p = 0.028), male sex (HR 2.35, p < 0.001), renal disease (HR 1.53, p = 0.017), and pulmonary disease (HR 1.45, p = 0.039) were independently associated with a higher 30-day mortality risk in patients with COVID-19 when adjusting for confounders. Conclusion: The prevalence of COVID-19 in hip fracture patients during the first wave of the pandemic was 9%, and was independently associated with a three-fold increased 30-day mortality risk.

Published
2022

3. IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic

Author

Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, MacLullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdus, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioannis, De Cicco, Annalisa, Diana, de la Fuente de Dios, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Luis, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgios, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nicholas, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, James, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexis, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgios, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgios, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatius, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, McAlinden, Gavan, McLean, Lucille, McDonald, Lorna, McIntyre, Joshua, McKay, Pamela, McKean, Greg, McShane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesus, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Jess, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, AnneMarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andreas, Panagiotopoulos, Elias, Panesar, Paul, Papadopoulos, Antonios, Spyridon, Papagiannis, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andres, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, James, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoros, Tottas, Stylianos, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlos, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, Zurrón Lobato, Miriam, Hall, A, Clement, N, Ojeda-Thies, C, Maclullich, A, Toro, G, Johansen, A, White, T, Duckworth, A, Abdul-Jabar, H, Abu-Rajab, R, Abugarja, A, Adam, K, Aguado Hernández, H, Améstica Lazcano, G, Anderson, S, Ansar, M, Antrobus, J, Aragón Achig, E, Archunan, M, Arrieta Salinas, M, Ashford-Wilson, S, Assens Gibert, C, Athanasopoulou, K, Awadelkarim, M, Baird, S, Bajada, S, Balakrishnan, S, Balasubramanian, S, Ballantyne, J, Bárcena Goitiandia, L, Barkham, B, Barmpagianni, C, Barres-Carsi, M, Barrett, S, Baskaran, D, Bell, J, Bell, K, Bell, S, Bellelli, G, Benchimol, J, Boietti, B, Boswell, S, Braile, A, Brennan, C, Brent, L, Brooke, B, Bruno, G, Burahee, A, Burns, S, Calabrò, G, Campbell, L, Carabelli, G, Carnegie, C, Carretero Cristobal, G, Caruana, E, Cassinello Ogea, M, Castellanos Robles, J, Castillon, P, Chakrabarti, A, Cecere, A, Chen, P, Clarke, J, Collins, G, Corrales Cardenal, J, Corsi, M, Cózar Adelantado, G, Craxford, S, Crooks, M, Cuarental-García, J, Cuthbert, R, Dall, G, Daskalakis, I, De Cicco, A, Diana, D, Demaria, P, Dereix, J, Díaz Jiménez, J, Dinamarca Montecinos, J, Do Le, H, Donoso Coppa, J, Drosos, G, Duffy, A, East, J, Eastwood, D, Elbahari, H, Elias de Molins Peña, C, Elmamoun, M, Emmerson, B, Escobar Sánchez, D, Faimali, M, Farré-Mercadé, M, Farrow, L, Fayez, A, Fell, A, Fenner, C, Ferguson, D, Finlayson, L, Flores Gómez, A, Freeman, N, French, J, Gabardo Calvo, S, Gagliardo, N, Garcia Albiñana, J, García Cruz, G, García de Cortázar Antolín, U, García Virto, V, Gealy, S, Gil Caballero, S, Gill, M, González González, M, Gopireddy, R, Guntley, D, Gurung, B, Guzmán Rosales, G, Haddad, N, Hafeez, M, Haller, P, Halligan, E, Hardie, J, Hawker, I, Helal, A, Herrera Cruz, M, Herreros Ruiz-Valdepeñas, R, Horton, J, Howells, S, Howieson, A, Hughes, L, Hünicken Torrez, F, Hurtado Ortega, A, Huxley, P, Hamid, H, Ilahi, N, Iliadis, A, Inman, D, Jadhao, P, Jandoo, R, Jawad, L, Jayatilaka, M, Jenkins, P, Jeyapalan, R, Johnson, D, Johnston, A, Joseph, S, Kapoor, S, Karagiannidis, G, Karanam, K, Kattakayam, F, Konarski, A, Kontakis, G, Labrador Hernández, G, Lancaster, V, Landi, G, Le, B, Liew, I, Logishetty, K, Lopez Marquez, A, Lopez, J, Lum, J, Macpherson, G, Madan, S, Mahroof, S, Malik-Tabassum, K, Mallina, R, Maqsood, A, Marson, B, Martin Legorburo, M, Martin-Perez, E, Martínez Jiménez, T, Martinez Martin, J, Mayne, A, Mayor, A, Mcalinden, G, Mclean, L, Mcdonald, L, Mcintyre, J, Mckay, P, Mckean, G, Mcshane, H, Medici, A, Meeke, C, Meldrum, E, Mendez, M, Mercer, S, Merino Perez, J, Mesa-Lampré, M, Mighton, S, Milne, K, Mohamed Yaseen, M, Moppett, I, Mora, J, Morales-Zumel, S, Moreno Fenoll, I, Mousa, A, Murray, A, Murray, E, Nair, R, Neary, F, Negri, G, Negus, O, Newham-Harvey, F, Ng, N, Nightingale, J, Noor Mohamed Anver, S, Nunag, P, O'Hare, M, Ollivere, B, Ortés Gómez, R, Owens, A, Page, S, Palloni, V, Panagiotopoulos, A, Panagiotopoulos, E, Panesar, P, Papadopoulos, A, Spyridon, P, Pareja Sierra, T, Park, C, Parwaiz, H, Paterson-Byrne, P, Patton, S, Pearce, J, Porter, M, Pellegrino, A, Pèrez Cuellar, A, Pezzella, R, Phadnis, A, Pinder, C, Piper, D, Powell-Bowns, M, Prieto Martín, R, Probert, A, Ramesh, A, Ramírez de Arellano, M, Renton, D, Rickman, S, Robertson, A, Roche Albero, A, Rodrigo Verguizas, J, Rodríguez Couso, M, Rooney, J, Sáez-López, P, Saldaña-Díaz, A, Santulli, A, Sanz Pérez, M, Sarraf, K, Scarsbrook, C, Scott, C, Scott, J, Shah, S, Sharaf, S, Sharma, S, Shirley, D, Siano, A, Simpson, J, Singh, A, Sinnett, T, Sisodia, G, Smith, P, Sophena Bert, E, Steel, M, Stewart, A, Stewart, C, Sugand, K, Sullivan, N, Sweeting, L, Symes, M, Tan, D, Tancredi, F, Tatani, I, Thomas, P, Thomson, F, Toner, N, Tong, A, Toro, A, Tosounidis, T, Tottas, S, Trinidad Leo, A, Tucker, D, Vemulapalli, K, Ventura Garces, D, Vernon, O, Viveros Garcia, J, Ward, A, Ward, K, Watson, K, Weerasuriya, T, Wickramanayake, U, Wilkinson, H, Windley, J, Wood, J, Wynell-Mayow, W, Zatti, G, Zeiton, M, Zurrón Lobato, M, Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, Maclullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdu, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioanni, De Cicco, Annalisa, Diana, de la Fuente de Dio, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Lui, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgio, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nichola, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, Jame, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexi, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgio, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgio, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatiu, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, Mcalinden, Gavan, Mclean, Lucille, Mcdonald, Lorna, Mcintyre, Joshua, Mckay, Pamela, Mckean, Greg, Mcshane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesu, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Je, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, Annemarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andrea, Panagiotopoulos, Elia, Panesar, Paul, Papadopoulos, Antonio, Spyridon, Papagianni, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andre, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, Jame, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoro, Tottas, Styliano, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlo, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, and Zurrón Lobato, Miriam

Subjects
Risk, Frailty, Communicable disease, Prognosi, COVID-19, Audit, Orthopaedic, Trauma, Hip fracture, Reporting standard, Meta-audit, Nosocomial, Infection, Geriatric, Outcome
Abstract

Aims: This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods: A multicentre collaboration among 112 centres in 14 countries collected data on all patients presenting with a hip fracture between 1st March-31st May 2020. Demographics, residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, management, ASA grade, length of stay, COVID-19 and 30-day mortality status were recorded. Results: A total of 7090 patients were included, with a mean age of 82.2 (range 50–104) years and 4959 (69.9%) being female. Of 651 (9.2%) patients diagnosed with COVID-19, 225 (34.6%) were positive at presentation and 426 (65.4%) were positive postoperatively. Positive COVID-19 status was independently associated with male sex (odds ratio (OR) 1.38, p = 0.001), residential care (OR 2.15, p < 0.001), inpatient fall (OR 2.23, p = 0.003), cancer (OR 0.63, p = 0.009), ASA grades 4 (OR 1.59, p = 0.008) or 5 (OR 8.28, p < 0.001), and longer admission (OR 1.06 for each increasing day, p < 0.001). Patients with COVID-19 at any time had a significantly lower chance of 30-day survival versus those without COVID-19 (72.7% versus 92.6%, p < 0.001). COVID-19 was independently associated with an increased 30-day mortality risk (hazard ratio (HR) 2.83, p < 0.001). Increasing age (HR 1.03, p = 0.028), male sex (HR 2.35, p < 0.001), renal disease (HR 1.53, p = 0.017), and pulmonary disease (HR 1.45, p = 0.039) were independently associated with a higher 30-day mortality risk in patients with COVID-19 when adjusting for confounders. Conclusion: The prevalence of COVID-19 in hip fracture patients during the first wave of the pandemic was 9%, and was independently associated with a three-fold increased 30-day mortality risk. Among COVID-19-positive patients, those who were older, male, with renal or pulmonary disease had a significantly higher 30-day mortality risk.

Published
2022

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