Have mortality rates in elderly patients with hip fractures changed during pandemic?

The mortality rates of patients over 65 years suffering from hip fractures were compared with/without infection related to SARS-CoV-2 virus during the 3 years of the pandemic.

Patients with femoral proximal region fracture (Type A-B) over 65 years were searched between January 2019 and February 2021 retrospectively. 487 patients met the inclusion criteria and were classified as Group I for surgery before and Group 2 for surgery during the pandemic. Demographic characteristics of the groups, hospitalization time before surgery, hospitalization total time, post-operative time until death and mortality rates were analyzed.

The survival rate of hip fracture patients over 65 was higher for the surgeries performed during the pandemic compared to Group I (p=0.032). Patients with 2, 3 or 4 comorbidities in Group I had higher mortality rates (p<0.05). According to fracture type, the mortality rates were higher in Group I (patients with femoral neck fractures) (p=0.005), in contrast mortality rate for trochanteric fractures (p>0.05) remained the same. Mortality rates of Group I and II did not differ according to either time from admission to operation, or time to surgery for fracture types. The mortality rates at 1, 4, 12, and 24 months were determined to be 8.83%, 20.14%, 36.75%, and 45.22%, respectively in Group I, and 8.86%, 23.15%, 32.51%, and 33.49% in Group II with no difference.

The approaches taken in extraordinary circumstances such as a pandemic can change the course or outcomes of a disease. These changes may emerge as different mortality rates between periods of time. Further studies to lower mortality rates depending on hip fracture are warranted especially for patients over 65.