Risk Factors of 120-Day Mortality Among Hip Fractures With Concomitant COVID-19 Infection

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Geriatric Medicine

Background:

• Hip fractures are a major cause of morbidity and mortality globally.
• The COVID-19 pandemic has exacerbated mortality rates in hip fracture patients.
• Risk factors for mortality in hip fracture patients with COVID-19 remain poorly understood.

Purpose of the Study:

• To identify risk factors associated with increased 120-day mortality in hip fracture patients with COVID-19.
• To analyze demographic, clinical, and surgical variables impacting mortality.
• To determine independent predictors of mortality in this patient cohort.

Main Methods:

• Retrospective analysis of 70 hip fracture patients with confirmed COVID-19 infection.
• Comparison of demographic, Nottingham Hip Fracture Score (NHFS), Charlson Comorbidity Index (CCI), and surgical data between survivor and non-survivor groups.
• Multivariate regression analysis to identify independent risk factors for mortality.

Main Results:

• The 120-day mortality rate was 47.1% (33 out of 70 patients).
• Delayed surgery (>36 hours) and internal fixation (e.g., dynamic hip screw, intramedullary nailing) were significantly associated with increased mortality.
• Higher NHFS and CCI were observed in non-survivors but were not independent predictors.

Conclusions:

• Hip fracture patients with COVID-19 face a substantial 120-day mortality risk.
• Delaying surgery beyond 36 hours and opting for internal fixation are independent risk factors for mortality.
• Timely surgical intervention and appropriate surgical technique are crucial for improving outcomes.