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10.1007/s43465-020-00272-7

http://scihub22266oqcxt.onion/10.1007/s43465-020-00272-7
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suck abstract from ncbi


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pmid33052147      Indian+J+Orthop 2020 ; 54 (Suppl 2): 386-396
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  • Peri-operative Outcomes and Predictors of Mortality in COVID-19 Positive Patients with Hip Fractures: A Multicentre Study in the UK #MMPMID33052147
  • De C; Wignall A; Giannoudis V; Jimenez A; Sturdee S; Aderinto J; Pandit H; Palan J; Gulati A
  • Indian J Orthop 2020[Dec]; 54 (Suppl 2): 386-396 PMID33052147show ga
  • AIM: This UK based multi-centre study reports clinical characteristics, early outcomes and predictors of mortality in 34 consecutive COVID-19-positive hip fractures so that the lessons learnt could be utilised in other parts of World who are at a different phase of the pandemic. METHODS: This study analysed patient admitted with hip fractures with COVID positive swabs, between March and May'2020 in three large hospitals covering a population of nearly two million. Data was collected on demographic profile, peri-operative variables, post-operative complications and mortality. The specific aim was to identify any variables, which could predict high 30-day mortality. RESULTS: Overall, 12% of hip fractures were COVID positive with the mortality rate of 41.2%. The higher age (p = 0.036) and male gender (p = 0.025) was significantly associated with mortality and most of the deaths were between American Society of Anaesthesiologists (ASA) grade 3 and 4 patients. The patients having intramedullary (IM) nailing were more likely to die (p = 0.02). There was no difference in laboratory parameters but there was significant difference in findings on chest radiographs (p < 0.001), post-operative oxygen requirements (p = 0.006) and early respiratory complications (p = 0.006). CONCLUSION: This study suggests that the mortality following surgery for a hip fracture in COVID-positive patients is strikingly high and is associated with higher age and male gender. Higher mortality has been observed for extracapsular fracture operated with intramedullary nailing. In the immediate post-operative period, rapid deterioration of chest imaging, higher oxygen requirement and early pulmonary complications can serve as warning signs and predicting factors for higher mortality.
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