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Survivorship Analysis in Asymptomatic COVID-19+ Hip Fracture Patients: Is There an Increase in Mortality?

Mason D Vialonga1, Luke G Menken1, Alex Tang1

  • 1Division of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center - RWJBarnabas Health, Jersey City, NJ, USA.

Hip & Pelvis
|March 31, 2022
PubMed

Insights

Asymptomatic hip fracture patients with COVID-19 had higher mortality rates at 30 and 90 days compared to those without the virus. COVID-19 positivity independently increased mortality risk in these patients.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Epidemiology

Background:

  • Hip fracture surgery outcomes are well-documented.
  • The impact of concurrent COVID-19 infection on hip fracture patients is less understood.
  • Asymptomatic COVID-19 infection presents a unique challenge in surgical patient management.

Purpose of the Study:

  • To compare 30-day and 90-day mortality rates in asymptomatic hip fracture patients with and without COVID-19.
  • To identify if COVID-19 status independently affects mortality in this patient cohort.

Main Methods:

  • Retrospective review of 149 consecutive hip fracture patients during the COVID-19 pandemic.
  • Comparison of mortality between asymptomatic COVID-19 positive and negative patient groups.
  • Primary outcomes: 30-day and 90-day mortality; secondary outcomes: length of stay, comorbidities.

Main Results:

  • COVID-19 positive patients exhibited significantly higher 30-day (26.7% vs 6.0%) and 90-day (41.7% vs 17.2%) mortality.
  • COVID-19 positive patients had a higher prevalence of pre-existing respiratory disease (46.7% vs 11.2%).
  • Cox regression indicated COVID-19 positivity as an independent risk factor for mortality, not pre-existing respiratory disease.

Conclusions:

  • COVID-19 positivity is an independent risk factor for increased mortality in asymptomatic hip fracture patients.
  • Optimized care protocols, including prompt orthogeriatric assessment and efficient operating room utilization, are crucial.
  • Managing COVID-19 in hip fracture patients requires specific considerations to maintain standards of care.
Abstract

Keywords:
COVID-19FractureGeriatricHipMortality

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