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COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU)

OBJECTIVES: COVID-19 can be a life-threatening illness, especially for older patients. The COVID-19 outbreak created a dramatic organizational challenge in treating infected patients requiring surgical treatment, like those suffering a proximal femur fracture, in a pandemic setting. We investigate t...

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Autores principales: Pass, Bastian, Vajna, Elvira, Knauf, Tom, Rascher, Katherine, Aigner, Rene, Eschbach, Daphne, Lendemans, Sven, Knobe, Matthias, Schoeneberg, Carsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AMDA - The Society for Post-Acute and Long-Term Care Medicine. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487770/
https://www.ncbi.nlm.nih.gov/pubmed/34678268
http://dx.doi.org/10.1016/j.jamda.2021.09.027
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author Pass, Bastian
Vajna, Elvira
Knauf, Tom
Rascher, Katherine
Aigner, Rene
Eschbach, Daphne
Lendemans, Sven
Knobe, Matthias
Schoeneberg, Carsten
author_facet Pass, Bastian
Vajna, Elvira
Knauf, Tom
Rascher, Katherine
Aigner, Rene
Eschbach, Daphne
Lendemans, Sven
Knobe, Matthias
Schoeneberg, Carsten
author_sort Pass, Bastian
collection PubMed
description OBJECTIVES: COVID-19 can be a life-threatening illness, especially for older patients. The COVID-19 outbreak created a dramatic organizational challenge in treating infected patients requiring surgical treatment, like those suffering a proximal femur fracture, in a pandemic setting. We investigate the impact of a COVID-19 infection in patients with a proximal femur fracture not only on mortality but also on quality of life (QoL), length of stay, and discharge target. DESIGN: Retrospective cohort analysis from July 1, 2020, to December 31, 2020. The Registry for Geriatric Trauma collected the data prospectively. Patient groups with and without COVID-19 infection were compared using linear and logistic regression models. SETTING AND PARTICIPANTS: Retrospective multicenter registry study including patients aged ≥70 years with proximal femur fracture requiring surgery from 107 certified Centers for Geriatric Trauma in Germany, Austria, and Switzerland. MEASURES: The occurrence and impact of COVID-19 infection in patients suffering a proximal femur fracture were measured regarding in-house mortality, length of stay, and discharge location. Moreover, QoL was measured by the validated EQ-5D-3L questionnaire. RESULTS: A total of 3733 patients were included in our study. Of them, 123 patients tested COVID-19 positive at admission. A COVID-19 infection resulted in a 5.95-fold higher mortality risk (odds ratio 5.95, P < .001], a length of stay prolonged by 4.21 days [regression coefficient (β) 4.21, P < .001], a reduced QoL (β −0.13, P = .001), and a change in discharge target, more likely to their home instead of another inpatient facility like a rehabilitation clinic (P = .013). CONCLUSIONS AND IMPLICATIONS: The impact of a COVID-19 infection in patients suffering a proximal femur fracture is tremendous. The infected patients presented a dramatic rise in mortality rate, were significantly less likely to be discharged to a rehabilitation facility, had a longer in-hospital stay, and a reduced QoL.
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spelling pubmed-84877702021-10-04 COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU) Pass, Bastian Vajna, Elvira Knauf, Tom Rascher, Katherine Aigner, Rene Eschbach, Daphne Lendemans, Sven Knobe, Matthias Schoeneberg, Carsten J Am Med Dir Assoc Original Study OBJECTIVES: COVID-19 can be a life-threatening illness, especially for older patients. The COVID-19 outbreak created a dramatic organizational challenge in treating infected patients requiring surgical treatment, like those suffering a proximal femur fracture, in a pandemic setting. We investigate the impact of a COVID-19 infection in patients with a proximal femur fracture not only on mortality but also on quality of life (QoL), length of stay, and discharge target. DESIGN: Retrospective cohort analysis from July 1, 2020, to December 31, 2020. The Registry for Geriatric Trauma collected the data prospectively. Patient groups with and without COVID-19 infection were compared using linear and logistic regression models. SETTING AND PARTICIPANTS: Retrospective multicenter registry study including patients aged ≥70 years with proximal femur fracture requiring surgery from 107 certified Centers for Geriatric Trauma in Germany, Austria, and Switzerland. MEASURES: The occurrence and impact of COVID-19 infection in patients suffering a proximal femur fracture were measured regarding in-house mortality, length of stay, and discharge location. Moreover, QoL was measured by the validated EQ-5D-3L questionnaire. RESULTS: A total of 3733 patients were included in our study. Of them, 123 patients tested COVID-19 positive at admission. A COVID-19 infection resulted in a 5.95-fold higher mortality risk (odds ratio 5.95, P < .001], a length of stay prolonged by 4.21 days [regression coefficient (β) 4.21, P < .001], a reduced QoL (β −0.13, P = .001), and a change in discharge target, more likely to their home instead of another inpatient facility like a rehabilitation clinic (P = .013). CONCLUSIONS AND IMPLICATIONS: The impact of a COVID-19 infection in patients suffering a proximal femur fracture is tremendous. The infected patients presented a dramatic rise in mortality rate, were significantly less likely to be discharged to a rehabilitation facility, had a longer in-hospital stay, and a reduced QoL. AMDA - The Society for Post-Acute and Long-Term Care Medicine. 2022-04 2021-10-04 /pmc/articles/PMC8487770/ /pubmed/34678268 http://dx.doi.org/10.1016/j.jamda.2021.09.027 Text en © 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Study
Pass, Bastian
Vajna, Elvira
Knauf, Tom
Rascher, Katherine
Aigner, Rene
Eschbach, Daphne
Lendemans, Sven
Knobe, Matthias
Schoeneberg, Carsten
COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU)
title COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU)
title_full COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU)
title_fullStr COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU)
title_full_unstemmed COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU)
title_short COVID-19 and Proximal Femur Fracture in Older Adults—A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU)
title_sort covid-19 and proximal femur fracture in older adults—a lethal combination? an analysis of the registry for geriatric trauma (atr-dgu)
topic Original Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487770/
https://www.ncbi.nlm.nih.gov/pubmed/34678268
http://dx.doi.org/10.1016/j.jamda.2021.09.027
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