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COVID-19 pandemic and hip fractures: impact and lessons learned

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...

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Autores principales: Arafa, Mohamed, Nesar, Samia, Abu-Jabeh, Hamza, Jayme, Ma Odette Remelou, Kalairajah, Yegappan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2020
Materias:
Hip
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659637/
https://www.ncbi.nlm.nih.gov/pubmed/33215151
http://dx.doi.org/10.1302/2633-1462.19.BJO-2020-0116.R1
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author Arafa, Mohamed
Nesar, Samia
Abu-Jabeh, Hamza
Jayme, Ma Odette Remelou
Kalairajah, Yegappan
author_facet Arafa, Mohamed
Nesar, Samia
Abu-Jabeh, Hamza
Jayme, Ma Odette Remelou
Kalairajah, Yegappan
author_sort Arafa, Mohamed
collection PubMed
description 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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spelling pubmed-76596372020-11-18 COVID-19 pandemic and hip fractures: impact and lessons learned Arafa, Mohamed Nesar, Samia Abu-Jabeh, Hamza Jayme, Ma Odette Remelou Kalairajah, Yegappan Bone Jt Open Hip 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. The British Editorial Society of Bone & Joint Surgery 2020-09-04 /pmc/articles/PMC7659637/ /pubmed/33215151 http://dx.doi.org/10.1302/2633-1462.19.BJO-2020-0116.R1 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Hip
Arafa, Mohamed
Nesar, Samia
Abu-Jabeh, Hamza
Jayme, Ma Odette Remelou
Kalairajah, Yegappan
COVID-19 pandemic and hip fractures: impact and lessons learned
title COVID-19 pandemic and hip fractures: impact and lessons learned
title_full COVID-19 pandemic and hip fractures: impact and lessons learned
title_fullStr COVID-19 pandemic and hip fractures: impact and lessons learned
title_full_unstemmed COVID-19 pandemic and hip fractures: impact and lessons learned
title_short COVID-19 pandemic and hip fractures: impact and lessons learned
title_sort covid-19 pandemic and hip fractures: impact and lessons learned
topic Hip
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659637/
https://www.ncbi.nlm.nih.gov/pubmed/33215151
http://dx.doi.org/10.1302/2633-1462.19.BJO-2020-0116.R1
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