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10.1186/s10195-021-00577-9

http://scihub22266oqcxt.onion/10.1186/s10195-021-00577-9
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suck abstract from ncbi


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pmid33818650      J+Orthop+Traumatol 2021 ; 22 (1): 15
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  • Early mortality in hip fracture patients admitted during first wave of the COVID-19 pandemic in Northern Italy: a multicentre study #MMPMID33818650
  • Dallari D; Zagra L; Cimatti P; Guindani N; D'Apolito R; Bove F; Casiraghi A; Catani F; D'Angelo F; Franceschini M; Masse A; Momoli A; Mosconi M; Ravasi F; Rivera F; Zatti G; Castelli CC
  • J Orthop Traumatol 2021[Apr]; 22 (1): 15 PMID33818650show ga
  • BACKGROUND: Treatment of hip fractures during the coronavirus disease 2019 (COVID-19) pandemic has posed unique challenges for the management of COVID-19-infected patients and the maintenance of standards of care. The primary endpoint of this study is to compare the mortality rate at 1 month after surgery in symptomatic COVID-positive patients with that of asymptomatic patients. A secondary endpoint of the study is to evaluate, in the two groups of patients, mortality at 1 month on the basis of type of fracture and type of surgical treatment. MATERIALS AND METHODS: For this retrospective multicentre study, we reviewed the medical records of patients hospitalised for proximal femur fracture at 14 hospitals in Northern Italy. Two groups were formed: COVID-19-positive patients (C+ group) presented symptoms, had a positive swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and received treatment for COVID-19; COVID-19-negative patients (C- group) were asymptomatic and tested negative for SARS-CoV-2. The two groups were compared for differences in time to surgery, survival rate and complications rate. The follow-up period was 1 month. RESULTS: Of the 1390 patients admitted for acute care for any reason, 477 had a proximal femur fracture; 53 were C+ but only 12/53 were diagnosed as such at admission. The mean age was > 80 years, and the mean American Society of Anesthesiologists (ASA) score was 3 in both groups. There was no substantial difference in time to surgery (on average, 2.3 days for the C+ group and 2.8 for the C- group). As expected, a higher mortality rate was recorded for the C+ group but not associated with the type of hip fracture or treatment. No correlation was found between early treatment (< 48 h to surgery) and better outcome in the C+ group. CONCLUSIONS: Hip fracture in COVID-19-positive patients accounted for 11% of the total. On average, the time to surgery was > 48 h, which reflects the difficulty of maintaining normal workflow during a medical emergency such as the present pandemic and notwithstanding the suspension of non-urgent procedures. Hip fracture was associated with a higher 30-day mortality rate in COVID-19-positive patients than in COVID-19-negative patients. This fact should be considered when communicating with patients and/or their family. Our data suggest no substantial difference in hip fracture management between patients with or without COVID-19 infection. In this sample, the COVID-19-positive patients were generally asymptomatic at admission; therefore, routine screening is recommended. LEVEL OF EVIDENCE: Therapeutic study, level 4.
  • |*Pandemics[MESH]
  • |Aged, 80 and over[MESH]
  • |COVID-19/*epidemiology[MESH]
  • |Comorbidity[MESH]
  • |Female[MESH]
  • |Hip Fractures/*mortality[MESH]
  • |Hospitalization/trends[MESH]
  • |Humans[MESH]
  • |Italy/epidemiology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |Survival Rate/trends[MESH]


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