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A multi-institutional study of short-term mortality in COVID-positive patients undergoing hip fracture surgery: is survival better than expected?
- Source :
-
European Journal of Orthopaedic Surgery & Traumatology . Jan2024, Vol. 34 Issue 1, p285-291. 7p. - Publication Year :
- 2024
-
Abstract
- Purpose: Early reports of 30-day mortality in COVID-positive patients with hip fracture were often over 30% and were higher than historical rates of 10% in pre-COVID studies. We conducted a multi-institutional retrospective cohort study to determine whether the incidence of 30-day mortality and complications in COVID-positive patients undergoing hip fracture surgery is as high as initially reported. Methods: A retrospective chart review was performed at 11 level I trauma centers from January 1, 2020 to May 1, 2022. Patients 50 years or older undergoing hip fracture surgery with a positive COVID test at the time of surgery were included. The primary outcome measurements were the incidence of 30-day mortality and complications. Post-operative outcomes were reported using proportions with 95% confidence interval (C.I.). Results: Forty patients with a median age of 71.5 years (interquartile range, 50–87 years) met the criteria. Within 30-days, four patients (10%; 95% C.I. 3–24%) died, four developed pneumonia, three developed thromboembolism, and three remained intubated post-operatively. Increased age was a statistically significant predictor of 30-day mortality (p = 0.01), with all deaths occurring in patients over 80 years. Conclusion: In this multi-institutional analysis of COVID-positive patients undergoing hip fracture surgery, 30-day mortality was 10%. The 95% C.I. did not include 30%, suggesting that survival may be better than initially reported. While COVID-positive patients with hip fractures have high short-term mortality, the clinical situation may not be as dire as initially described, which may reflect initial publication bias, selection bias introduced by testing, or other issues. Levels of Evidence: Therapeutic Level III. [ABSTRACT FROM AUTHOR]
- Subjects :
- *RESEARCH
*PNEUMONIA
*RESPIRATORY diseases
*OBESITY
*COVID-19
*CONFIDENCE intervals
*TRAUMA centers
*AGE distribution
*INTUBATION
*TIME
*HIP fractures
*SURGICAL complications
*SURGERY
*PATIENTS
*RETROSPECTIVE studies
*ACQUISITION of data
*DISEASE incidence
*DIABETES
*FISHER exact test
*MANN Whitney U Test
*RISK assessment
*TREATMENT effectiveness
*T-test (Statistics)
*MEDICAL records
*DESCRIPTIVE statistics
*THROMBOEMBOLISM
*FRACTURE fixation
*RESEARCH funding
*DISEASE complications
*DATA analysis software
*COMORBIDITY
*DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 16338065
- Volume :
- 34
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- European Journal of Orthopaedic Surgery & Traumatology
- Publication Type :
- Academic Journal
- Accession number :
- 174645189
- Full Text :
- https://doi.org/10.1007/s00590-023-03620-z