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Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study

Background: Older patients are at increased risk of severe COVID-19 infection and associated mortality. There are limited data evaluating the outcome of older patients with hip fractures treated during the COVID-19 pandemic, and it has been suggested that these patients should be treated non-operati...

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Autores principales: Burahee, Abdus S, Barry, Veronica E, Sutcliffe, Robert P, Mahroof, Sabreena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888253/
https://www.ncbi.nlm.nih.gov/pubmed/33595434
http://dx.doi.org/10.1051/sicotj/2021001
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author Burahee, Abdus S
Barry, Veronica E
Sutcliffe, Robert P
Mahroof, Sabreena
author_facet Burahee, Abdus S
Barry, Veronica E
Sutcliffe, Robert P
Mahroof, Sabreena
author_sort Burahee, Abdus S
collection PubMed
description Background: Older patients are at increased risk of severe COVID-19 infection and associated mortality. There are limited data evaluating the outcome of older patients with hip fractures treated during the COVID-19 pandemic, and it has been suggested that these patients should be treated non-operatively due to high mortality risk. The aim of this study was to report the outcomes of COVID-19 infected hip fracture patients treated at a single centre. Methods: This was a retrospective cohort study. Data were collected from February 2020 (after the first confirmed COVID-19 infected patient was reported in the Midlands region of the UK). All patients admitted to the hospital with femoral neck fractures were included. Patient demographics, comorbidity, COVID-19 status, and short-term clinical outcomes were obtained by review of electronic medical records. The outcomes of COVID-19 infected patients were compared with non-COVID-19 patients treated during the study period. Results: Twenty-nine patients were included (mean age of 80 years), of whom 14 (48%) were tested positive for COVID-19 infection in the postoperative period. Overall, 26 patients (90%) underwent surgical treatment. COVID-19 infected patients had significantly higher Charlson comorbidity scores compared to the control group (5 vs. 4; p = 0.047). Only 5 COVID-19 infected patients (36%) required supplemental oxygen therapy in the postoperative period, and no patients required respiratory or other organ support. The 30-day mortality rate in COVID-19 patients was 14% compared to 0% in the negative controls (p = 0.22). Interpretation: COVID-19 infection did not increase the mortality rate of older patients undergoing surgery for hip fractures during the pandemic. The authors recommend careful assessment of patient fitness and prompt surgical treatment. In addition, it was noted that nearly all admissions were either given large boluses of Vitamin D or were on maintenance supplementation, which may have affected the severity of the response to COVID-19 infections.
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spelling pubmed-78882532021-02-22 Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study Burahee, Abdus S Barry, Veronica E Sutcliffe, Robert P Mahroof, Sabreena SICOT J Original Article Background: Older patients are at increased risk of severe COVID-19 infection and associated mortality. There are limited data evaluating the outcome of older patients with hip fractures treated during the COVID-19 pandemic, and it has been suggested that these patients should be treated non-operatively due to high mortality risk. The aim of this study was to report the outcomes of COVID-19 infected hip fracture patients treated at a single centre. Methods: This was a retrospective cohort study. Data were collected from February 2020 (after the first confirmed COVID-19 infected patient was reported in the Midlands region of the UK). All patients admitted to the hospital with femoral neck fractures were included. Patient demographics, comorbidity, COVID-19 status, and short-term clinical outcomes were obtained by review of electronic medical records. The outcomes of COVID-19 infected patients were compared with non-COVID-19 patients treated during the study period. Results: Twenty-nine patients were included (mean age of 80 years), of whom 14 (48%) were tested positive for COVID-19 infection in the postoperative period. Overall, 26 patients (90%) underwent surgical treatment. COVID-19 infected patients had significantly higher Charlson comorbidity scores compared to the control group (5 vs. 4; p = 0.047). Only 5 COVID-19 infected patients (36%) required supplemental oxygen therapy in the postoperative period, and no patients required respiratory or other organ support. The 30-day mortality rate in COVID-19 patients was 14% compared to 0% in the negative controls (p = 0.22). Interpretation: COVID-19 infection did not increase the mortality rate of older patients undergoing surgery for hip fractures during the pandemic. The authors recommend careful assessment of patient fitness and prompt surgical treatment. In addition, it was noted that nearly all admissions were either given large boluses of Vitamin D or were on maintenance supplementation, which may have affected the severity of the response to COVID-19 infections. EDP Sciences 2021-02-17 /pmc/articles/PMC7888253/ /pubmed/33595434 http://dx.doi.org/10.1051/sicotj/2021001 Text en © The Authors, published by EDP Sciences, 2021 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Burahee, Abdus S
Barry, Veronica E
Sutcliffe, Robert P
Mahroof, Sabreena
Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
title Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
title_full Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
title_fullStr Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
title_full_unstemmed Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
title_short Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
title_sort older patients with proximal femur fractures and sars-cov-2 infection – an observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888253/
https://www.ncbi.nlm.nih.gov/pubmed/33595434
http://dx.doi.org/10.1051/sicotj/2021001
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