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Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic

Incidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databas...

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Autores principales: Raheman, Firas J., Rojoa, Djamila M., Nayan Parekh, Jvalant, Berber, Reshid, Ashford, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115062/
https://www.ncbi.nlm.nih.gov/pubmed/33980936
http://dx.doi.org/10.1038/s41598-021-89617-2
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author Raheman, Firas J.
Rojoa, Djamila M.
Nayan Parekh, Jvalant
Berber, Reshid
Ashford, Robert
author_facet Raheman, Firas J.
Rojoa, Djamila M.
Nayan Parekh, Jvalant
Berber, Reshid
Ashford, Robert
author_sort Raheman, Firas J.
collection PubMed
description Incidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I(2) = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.
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spelling pubmed-81150622021-05-12 Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic Raheman, Firas J. Rojoa, Djamila M. Nayan Parekh, Jvalant Berber, Reshid Ashford, Robert Sci Rep Article Incidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I(2) = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients. Nature Publishing Group UK 2021-05-12 /pmc/articles/PMC8115062/ /pubmed/33980936 http://dx.doi.org/10.1038/s41598-021-89617-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Raheman, Firas J.
Rojoa, Djamila M.
Nayan Parekh, Jvalant
Berber, Reshid
Ashford, Robert
Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_full Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_fullStr Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_full_unstemmed Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_short Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_sort meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the covid-19 pandemic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115062/
https://www.ncbi.nlm.nih.gov/pubmed/33980936
http://dx.doi.org/10.1038/s41598-021-89617-2
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