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8. Modification of a Validated Risk Stratification Tool to Characterize Geriatric Hip Fracture Outcomes and Optimize Care in a Post COVID-19 World

Author

Konda, Sanjit R., Ranson, Rachel A., Solasz, Sara J., Dedhia, Nicket, Lott, Ariana, Bird, Mackenzie L., Landes, Emma K., Aggarwal, Vinay K., Bosco, Joseph A., III, Furgiuele, David L., Gould, Jason, Lyon, Thomas R., McLaurin, Toni M., Tejwani, Nirmal C., Zuckerman, Joseph D., Leucht, Philipp, Ganta, Abhishek, and Egol, Kenneth A.

Published
2020
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10. COVID-19 vaccination improved outcomes in the treatment of geriatric hip fractures between December 2020 and January 2022.

Author

Konda, Sanjit R, Meltzer Bruhn, Ariana T, Esper, Garrett W, Solasz, Sara J, Ganta, Abhishek, and Egol, Kenneth A

Subjects
DISEASE risk factors, VACCINATION, MEDICAL quality control, LENGTH of stay in hospitals, INTENSIVE care units, COVID-19, IMMUNIZATION, ANALYSIS of variance, COVID-19 vaccines, ATTITUDE (Psychology), MULTIVARIATE analysis, HIP fractures, PATIENT readmissions, TREATMENT effectiveness, RISK assessment, T-test (Statistics), COMPARATIVE studies, CHI-squared test, DESCRIPTIVE statistics, DEMOGRAPHY, LOGISTIC regression analysis
Abstract

Introduction: Geriatric hip fracture patients are at high risk for perioperative morbidity and mortality from COVID-19. This study analyses the impact of COVID-19 vaccination on geriatric hip fracture outcomes. We hypothesise that having the COVID-19 vaccine improves outcomes for geriatric patients treated for hip fracture. Methods: Between December 2020 and January 2022, 506 patients treated for hip fracture were analysed for demographics, hospital quality measures, and outcomes. Patients were grouped according to vaccine series administration status. During the study period, there were 329 (65%) unvaccinated patients (NV), 14 (3%) partially vaccinated (PV) patients, 138 (27%) fully vaccinated (FV) patients, and 25 (5%) patients received a booster shot (BV). Variables were compared using chi square, independent sample t -tests or ANOVA as appropriate. Multivariable logistic regression was used to independently assess the impact of vaccination. Results: The rate of minor complications decreased if any vaccination status was achieved (NV: 37.99%, PV: 21.34%, FV: 28.26%, BV: 20.00%; p = 0.054). Vaccinated patients had a decreased need for Intensive Care Unit (ICU) level care (NV: 14.89%, PV: 7.14%, FV: 5.80%, BV: 8.00%; p = 0.038). There were no differences in inpatient or 30-day mortality, major complications, length of stay, home discharge, or readmission within 30 or 90 days. Vaccination against COVID-19 was independently protective against the need for ICU level care. Additionally, female gender and vaccination against COVID-19 decreased the rate of minor complications. Older age and higher comorbidity burden increased the rate of minor complications. Discussion: In the hip fracture population, vaccination against COVID-19 was protective against the need for ICU level care and decreased overall minor complications. Larger studies are needed to determine if vaccination decreases mortality in this population. These findings have resource allocation implications including ICU bed availability during pandemics and patient outreach to improve vaccination status. [ABSTRACT FROM AUTHOR]

Published
2023
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