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Analyzing Mid-to-Long Term Mortality Rates and Associated Factors of Geriatric Patients with Hip Fractures during the COVID-19 Pandemic: A Single Centre Prospective Study

Year 2022, Volume: 13 Issue: 4, 491 - 497, 01.10.2022

Batuhan Gencer , Özgür Doğan

https://doi.org/10.31067/acusaglik.1034439

Abstract

Objective
Our objective was to evaluate the mid-to-long term mortality rates (with an average of 1-year follow-up) and associated factors of geriatric patients with hip fractures during the COVID-19 pandemic.
Methods
Prospectively followed-up 104 geriatric patients over 65 years old, with hip fractures during the pandemic, 89 of which underwent surgery, were evaluated. A control group of 126 geriatric patients treated for hip fractures before the pandemic was formed. Patient demographics, initial SARS-Cov-2 Reverse Transcriptase PCR test results, fracture type, type of surgery performed, length of stay (LOS) in hospital early complications were analyzed.
Results
Mid-to-long term mortality rate of geriatric patients with hip fractures treated during the pandemic period was 42.3% whereas the mortality rate of control group was calculated as 38.9% (p=0.599). Patients that were unfit for surgery and patients with positive initial SARS-Cov-2 Reverse Transcriptase PCR test were significantly related with higher mortality (p<0.001 for each). Among the geriatric patients with operated hip fractures, presence of early complications, longer LOS in intensive care units postoperatively and longer total LOS in hospital were significantly related with higher mortality (p=0.017, p=0.001 and p=0.045; respectively).
Conclusion
Patients with a positive initial SARS-Cov-2 Reverse Transcriptase PCR test and deemed as unfit for surgery have higher mortality rates. On the other hand, with correct management and separation of COVID and non-COVID patients and medical staff, increased mortality may be avoidable among patients treated surgically. Alas, it may not always be possible to avoid some of the related factors of increased mortality.

Keywords

COVID-19 pandemic geriatric patients hip fractures mortality length of stay

References

  • 1. WHO Coronavirus (COVID-19) Dashboard. World Health Organization. Accessed August 26, 2021. https://covid19.who.int/
  • 2. Acar AC, Er AG, Burduroğlu HC, et al. Projecting the course of COVID-19 in Turkey: A probabilistic modeling approach. Turk J Med Sci. 2021;51(1):16-27.
  • 3. Ojeda-Thies C, Cuarental-García J, García-Gómez E, et al. Hip fracture care and mortality among patients treated in dedicated COVID-19 and non-COVID-19 circuits. Eur Geriatr Med. 2021 Aug;12(4):1–9.
  • 4. Kawamura K, Kamiya M, Suzumura S, et al. Impact of the Coronavirus Disease 2019 Outbreak on Activity and Exercise Levels among Older Patients. J Nutr Health Aging. 2021;25(7):921-5.
  • 5. Ripa M, Galli L, Poli A, et al. Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect. 2021;27(3):451-7.
  • 6. Egol KA, Konda SR, Bird ML, et al. Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective. J Orthop Trauma. 2020;34 (8):395-402.
  • 7. Thakrar A, Chui K, Kapoor A, et al. Thirty-Day Mortality Rate of Patients with Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom. J Orthop Trauma. 2020;34(9): e325-9.
  • 8. Cheruvu MS, Bhachu DS, Mulrain J, et al. Effect of COVID-19 on a rural orthopaedic hip fracture service. Bone Jt Open. 2020;1(8): 500-7.
  • 9. Narang A, Chan G, Aframian A, et al. Thirty-day mortality following surgical management of hip fractures during the COVID-19 pandemic: findings from a prospective multi-center UK study. Int Orthop. 2021;45(1):23-31.
  • 10. Grassi A, Andriolo L, Golinelli D, et al. Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case-Control Study from a Single Center in Italy. Int J Environ Res Public Health. 2021 May;18(10):5205.
  • 11. Oputa TJ, Dupley L, Bourne JT; North West COVID NOF Study Group. One Hundred Twenty-Day Mortality Rates for Hip Fracture Patients with COVID-19 Infection. Clin Orthop Surg. 2021 Jun;13(2):135-43.
  • 12. Chui K, Thakrar A, Shankar S. Evaluating the efficacy of a two-site ('COVID-19' and 'COVID-19-free') trauma and orthopaedic service for the management of hip fractures during the COVID-19 pandemic in the UK. Bone Jt Open. 2020;1(6):190-7.
  • 13. Thakur B, Dubey P, Benitez J, et al. A systematic review and meta-analysis of geographic differences in comorbidities and associated severity and mortality among individuals with COVID-19. Sci Rep. 2021 Apr;11(1):8562.
  • 14. Handoll HH, Parker MJ. Conservative versus operative treatment for hip fractures in adults. Cochrane Database Syst Rev. 2008;(3):CD000337.
  • 15. Okike K, Hasegawa IG. Current Trends in the Evaluation and Management of Nondisplaced Femoral Neck Fractures in the Elderly. J Am Acad Orthop Surg. 2021;29(4):e154-64.
  • 16. COVID-19 deaths worldwide per million population, by country. Statistika. Accessed August 25, 2021. https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/
  • 17. Sciard D, Cattano D, Hussain M, et al. Perioperative management of proximal hip fractures in the elderly: the surgeon and the anesthesiologist. Minerva Anestesiol. 2011;77(7):715-22. 18. Basques BA, Bohl DD, Golinvaux NS, et al. Postoperative length of stay and 30-day readmission after geriatric hip fracture: an analysis of 8434 patients. J Orthop Trauma. 2015 Mar;29(3):e115-20.

Year 2022, Volume: 13 Issue: 4, 491 - 497, 01.10.2022

Batuhan Gencer , Özgür Doğan

https://doi.org/10.31067/acusaglik.1034439

Abstract

References

  • 1. WHO Coronavirus (COVID-19) Dashboard. World Health Organization. Accessed August 26, 2021. https://covid19.who.int/
  • 2. Acar AC, Er AG, Burduroğlu HC, et al. Projecting the course of COVID-19 in Turkey: A probabilistic modeling approach. Turk J Med Sci. 2021;51(1):16-27.
  • 3. Ojeda-Thies C, Cuarental-García J, García-Gómez E, et al. Hip fracture care and mortality among patients treated in dedicated COVID-19 and non-COVID-19 circuits. Eur Geriatr Med. 2021 Aug;12(4):1–9.
  • 4. Kawamura K, Kamiya M, Suzumura S, et al. Impact of the Coronavirus Disease 2019 Outbreak on Activity and Exercise Levels among Older Patients. J Nutr Health Aging. 2021;25(7):921-5.
  • 5. Ripa M, Galli L, Poli A, et al. Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect. 2021;27(3):451-7.
  • 6. Egol KA, Konda SR, Bird ML, et al. Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective. J Orthop Trauma. 2020;34 (8):395-402.
  • 7. Thakrar A, Chui K, Kapoor A, et al. Thirty-Day Mortality Rate of Patients with Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom. J Orthop Trauma. 2020;34(9): e325-9.
  • 8. Cheruvu MS, Bhachu DS, Mulrain J, et al. Effect of COVID-19 on a rural orthopaedic hip fracture service. Bone Jt Open. 2020;1(8): 500-7.
  • 9. Narang A, Chan G, Aframian A, et al. Thirty-day mortality following surgical management of hip fractures during the COVID-19 pandemic: findings from a prospective multi-center UK study. Int Orthop. 2021;45(1):23-31.
  • 10. Grassi A, Andriolo L, Golinelli D, et al. Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case-Control Study from a Single Center in Italy. Int J Environ Res Public Health. 2021 May;18(10):5205.
  • 11. Oputa TJ, Dupley L, Bourne JT; North West COVID NOF Study Group. One Hundred Twenty-Day Mortality Rates for Hip Fracture Patients with COVID-19 Infection. Clin Orthop Surg. 2021 Jun;13(2):135-43.
  • 12. Chui K, Thakrar A, Shankar S. Evaluating the efficacy of a two-site ('COVID-19' and 'COVID-19-free') trauma and orthopaedic service for the management of hip fractures during the COVID-19 pandemic in the UK. Bone Jt Open. 2020;1(6):190-7.
  • 13. Thakur B, Dubey P, Benitez J, et al. A systematic review and meta-analysis of geographic differences in comorbidities and associated severity and mortality among individuals with COVID-19. Sci Rep. 2021 Apr;11(1):8562.
  • 14. Handoll HH, Parker MJ. Conservative versus operative treatment for hip fractures in adults. Cochrane Database Syst Rev. 2008;(3):CD000337.
  • 15. Okike K, Hasegawa IG. Current Trends in the Evaluation and Management of Nondisplaced Femoral Neck Fractures in the Elderly. J Am Acad Orthop Surg. 2021;29(4):e154-64.
  • 16. COVID-19 deaths worldwide per million population, by country. Statistika. Accessed August 25, 2021. https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/
  • 17. Sciard D, Cattano D, Hussain M, et al. Perioperative management of proximal hip fractures in the elderly: the surgeon and the anesthesiologist. Minerva Anestesiol. 2011;77(7):715-22. 18. Basques BA, Bohl DD, Golinvaux NS, et al. Postoperative length of stay and 30-day readmission after geriatric hip fracture: an analysis of 8434 patients. J Orthop Trauma. 2015 Mar;29(3):e115-20.
There are 17 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Research Article
Authors

Batuhan Gencer 0000-0003-0041-7378

Özgür Doğan 0000-0002-5913-0411

Publication Date October 1, 2022
Submission Date December 9, 2021
Published in Issue Year 2022Volume: 13 Issue: 4

Cite

EndNote Gencer B, Doğan Ö (October 1, 2022) Analyzing Mid-to-Long Term Mortality Rates and Associated Factors of Geriatric Patients with Hip Fractures during the COVID-19 Pandemic: A Single Centre Prospective Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 13 4 491–497.
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