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10.1302/2633-1462.19.BJO-2020-0116.R1

http://scihub22266oqcxt.onion/10.1302/2633-1462.19.BJO-2020-0116.R1
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33215151!7659637!33215151
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suck abstract from ncbi


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pmid33215151      Bone+Jt+Open 2020 ; 1 (9): 530-540
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  • COVID-19 pandemic and hip fractures: impact and lessons learned #MMPMID33215151
  • Arafa M; Nesar S; Abu-Jabeh H; Jayme MOR; Kalairajah Y
  • Bone Jt Open 2020[Sep]; 1 (9): 530-540 PMID33215151show ga
  • AIMS: The coronavirus disease (COVID)-19 pandemic forced an unprecedented period of challenge to the NHS in the UK where hip fractures in the elderly population are a major public health concern. There are approximately 76,000 hip fractures in the UK each year which make up a substantial proportion of the trauma workload of an average orthopaedic unit. This study aims to assess the impact of the COVID-19 pandemic on hip fracture care service and the emerging lessons to withstand any future outbreaks. METHODS: Data were collected retrospectively on 157 hip fractures admitted from March to May 2019 and 2020. The 2020 group was further subdivided into COVID-positive and COVID-negative. Data including the four-hour target, timing to imaging, hours to operation, anaesthetic and operative details, intraoperative complications, postoperative reviews, COVID status, Key Performance Indicators (KPIs), length of stay, postoperative complications, and the 30-day mortality were compiled from computer records and our local National Hip Fracture Database (NHFD) export data. RESULTS: Hip fractures and inpatient falls significantly increased by 61.7% and 7.2% respectively in the 2020 group. A significant difference was found among the three groups regarding anaesthetic preparation time, anaesthetic time, and recovery time. The mortality rate in the 2020 COVID-positive group (36.8%) was significantly higher than both the 2020 COVID-negative and 2019 groups (11.5% and 11.7% respectively). The hospital stay was significantly higher in the COVID-positive group (mean of 24.21 days (SD 19.29)). CONCLUSION: COVID-19 has had notable effects on the hip fracture care service: hip fracture rates increased significantly. There were inefficiencies in theatre processes for which we have recommended the use of alternate theatres. COVID-19 infection increased the 30-day mortality and hospital stay in hip fractures. More research needs to be done to reduce this risk.Cite this article: Bone Joint Open 2020;1-9:530-540.
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