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[Translated article] Has the COVID-19 lockdown influenced the mortality of hip fracture? Analysis of one-year
A Garcia-Reza1, D M Dominguez-Prado1, P Balvis-Balvis1
1Servicio de Cirugía Ortopédica y Traumatología, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
Insights
COVID-19 lockdowns did not increase one-year mortality for intracapsular hip fractures. Hospital management remained consistent, preventing adverse outcomes in hip fracture patients during the pandemic.
Area of Science:
- Orthopaedic Surgery
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic and associated social confinement measures significantly impacted healthcare systems globally.
- Intracapsular hip fractures are a common and serious injury, particularly in elderly populations.
- Understanding the impact of pandemic-related disruptions on patient outcomes is crucial for healthcare preparedness.
Purpose of the Study:
- To analyze the one-year mortality rate in patients with intracapsular hip fractures admitted during the COVID-19 lockdown period.
- To compare these mortality rates with data from preceding years before the pandemic.
- To assess the influence of social confinement on hip fracture patient outcomes.
Main Methods:
- A retrospective observational study comparing a pandemic cohort (March-June 2020) with a pre-pandemic control cohort (2017-2019).
- Data collected included 30-day and one-year mortality, orthopaedic complications, comorbidities, and length of hospital stay.
- Statistical analysis was performed to compare outcomes between the two groups.
Main Results:
- No statistically significant differences were observed in 30-day mortality (9.7% vs. 4.7%) or one-year mortality (21% vs. 16.9%) between the pandemic and control groups.
- The pandemic group showed a trend towards decreased surgical delay and shorter mean hospital stay, though not statistically significant.
- The distribution of hip fracture types shifted, with a predominance of intracapsular fractures during the lockdown.
Conclusions:
- Maintaining pre-pandemic hospital management protocols was effective in preventing increased mortality for intracapsular hip fractures during the COVID-19 State of Alarm.
- The study demonstrates the resilience of established clinical pathways in managing acute orthopaedic conditions during public health crises.
- Effective management strategies can mitigate negative impacts on patient outcomes even amidst severe societal disruptions.
Introduction And Objectives:
The main objective of this study is to analyse the one-year mortality in patients with intracapsular hip fracture who were admitted during severe social confinement in the first months of the COVID-19 lockdown and compare it with previous years.
Material And Methods:
Retrospective observational study in which a cohort from March 14 to June 21, 2020 (pandemic group, n=62) was compared with a control cohort on the same dates in the years 2017, 2018 and 2019 (control group, n=172). Thirty-day-mortality and one-year-mortality, orthopaedic complications, ASA grade, comorbidities, diagnosis and treatment, time to surgery and mean stay were measured.
Results:
No significant differences were found in 30-day mortality (p=0.156; 9.7% compared to 4.7%) or in one-year mortality (p=0.47) between the pandemic group (21%) and the control one (16.9%). A decrease in surgical delay and mean stay was observed in the pandemic group, although without statistical significance.
Conclusion:
The State of Alarm modified the distribution of the type of hip fracture with a predominance of intracapsular fracture. Maintaining the same hospital management as prior to the pandemic period made it possible not to increase 30-day mortality and one-year mortality in patients with intracapsular hip fracture.
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