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Increased 90-Day Morbidity and Mortality Among Patients With Hip Fracture During the COVID-19 Pandemic

Megan M Mizera, Danielle Putur, Anna Tarasova

    Orthopedics
    |August 29, 2024
    PubMed

    Insights

    Hip fracture surgery is safe during the COVID-19 pandemic. Patients with coronavirus disease 2019 (COVID-19) faced higher risks of pneumonia and mortality, but overall surgical outcomes remained comparable.

    Area of Science:

    • Orthopedic surgery
    • Infectious disease epidemiology
    • Geriatric medicine

    Background:

    • The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
    • Institutions at the epicenter of the outbreak had to adapt surgical practices with limited understanding of the virus.
    • Geriatric hip fracture fixation continued under strict guidelines despite the pandemic's uncertainties.

    Purpose of the Study:

    • To compare outcomes of geriatric hip fracture surgery during the COVID-19 pandemic peak versus pre-pandemic periods.
    • To assess the safety and complication rates of surgical hip fracture fixation during a public health crisis.
    • To identify specific risks associated with COVID-19 in patients undergoing hip fracture surgery.

    Main Methods:

    • Retrospective cohort study comparing patients from December 2019 to June 2020.
    • Analysis of surgical fixation for hip fractures in geriatric patients.
    • Primary outcome: 90-day mortality; Secondary outcomes: pneumonia, thromboembolic events, readmission, and cardiac events.

    Main Results:

    • The pandemic cohort (2020) showed a significantly higher risk of pneumonia (4.27 times) compared to the pre-pandemic cohort (2019).
    • Patients with COVID-19 experienced increased risks of pneumonia (5.09 times) and postoperative mortality (5.38 times).
    • No increased risk of thromboembolism was observed, attributed to universal heparin anticoagulation.

    Conclusions:

    • Surgical fixation of hip fractures is a safe procedure even during the peak of a pandemic.
    • COVID-19 infection in hip fracture patients is associated with increased risks of pneumonia and mortality.
    • Adherence to strict guidelines and prophylactic anticoagulation can mitigate certain surgical risks during pandemics.
    Abstract

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