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Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center

To date, literature has depicted an increase in mortality among patients with hip fractures, directly related to acute coronavirus disease 2019 (COVID-19) infection and not due to underlying comorbidities. Usual orthogeriatric pathway in our Department was disrupted during the pandemic. This study a...

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Autores principales: Boukebous, Baptiste, Maillot, Cédric, Neouze, Angèle, Esnault, Hélène, Gao, Fei, Biau, David, Rousseau, Marc-Antoine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880866/
https://www.ncbi.nlm.nih.gov/pubmed/35213561
http://dx.doi.org/10.1371/journal.pone.0263680
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author Boukebous, Baptiste
Maillot, Cédric
Neouze, Angèle
Esnault, Hélène
Gao, Fei
Biau, David
Rousseau, Marc-Antoine
author_facet Boukebous, Baptiste
Maillot, Cédric
Neouze, Angèle
Esnault, Hélène
Gao, Fei
Biau, David
Rousseau, Marc-Antoine
author_sort Boukebous, Baptiste
collection PubMed
description To date, literature has depicted an increase in mortality among patients with hip fractures, directly related to acute coronavirus disease 2019 (COVID-19) infection and not due to underlying comorbidities. Usual orthogeriatric pathway in our Department was disrupted during the pandemic. This study aimed to evaluate early mortality within 30 days, in 2019 and 2020 in our Level 1 trauma-center. We compared two groups of patients aged >60 years, with osteoporotic upper hip fractures, in February/March/April 2020 and February/March/April 2019, in our level 1 trauma center. A total of 102 and 79 patients met the eligibility criteria in 2019 and 2020, respectively. Mortality was evaluated, merging our database with the French open database for death from the INSEE, which is prospectively updated each month. Causes of death were recorded. Charlson Comorbidity Index was evaluated for comorbidities, Instrumental Activity of Daily Living (IADL), and Activity of Daily Living (ADL) scores were assessed for autonomy. There were no differences in age, sex, fracture type, Charlson Comorbidity Index, IADL, and ADL. 19 patients developed COVID-19 infection. The 30-day survival was 97% (95% CI, 94%–100%) in 2019 and 86% (95% CI, 79%–94%) in 2020 (HR = 5, 95%CI, 1.4–18.2, p = 0.013). In multivariable Cox’PH model, the period (2019/2020) was significantly associated to the 30-day mortality (HR = 6.4, 95%CI, 1.7–23, p = 0.005) and 6-month mortality (HR = 3.4, 95%CI, 1.2–9.2, p = 0.01). COVID infection did not modify significantly the 30-day and 6-month mortality. This series brought new important information, early mortality significantly increased because of underlying disease decompensation. Minimal comprehensive care should be maintained in all circumstances in order to avoid excess of mortality among elderly population with hip fractures.
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spelling pubmed-88808662022-02-26 Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center Boukebous, Baptiste Maillot, Cédric Neouze, Angèle Esnault, Hélène Gao, Fei Biau, David Rousseau, Marc-Antoine PLoS One Research Article To date, literature has depicted an increase in mortality among patients with hip fractures, directly related to acute coronavirus disease 2019 (COVID-19) infection and not due to underlying comorbidities. Usual orthogeriatric pathway in our Department was disrupted during the pandemic. This study aimed to evaluate early mortality within 30 days, in 2019 and 2020 in our Level 1 trauma-center. We compared two groups of patients aged >60 years, with osteoporotic upper hip fractures, in February/March/April 2020 and February/March/April 2019, in our level 1 trauma center. A total of 102 and 79 patients met the eligibility criteria in 2019 and 2020, respectively. Mortality was evaluated, merging our database with the French open database for death from the INSEE, which is prospectively updated each month. Causes of death were recorded. Charlson Comorbidity Index was evaluated for comorbidities, Instrumental Activity of Daily Living (IADL), and Activity of Daily Living (ADL) scores were assessed for autonomy. There were no differences in age, sex, fracture type, Charlson Comorbidity Index, IADL, and ADL. 19 patients developed COVID-19 infection. The 30-day survival was 97% (95% CI, 94%–100%) in 2019 and 86% (95% CI, 79%–94%) in 2020 (HR = 5, 95%CI, 1.4–18.2, p = 0.013). In multivariable Cox’PH model, the period (2019/2020) was significantly associated to the 30-day mortality (HR = 6.4, 95%CI, 1.7–23, p = 0.005) and 6-month mortality (HR = 3.4, 95%CI, 1.2–9.2, p = 0.01). COVID infection did not modify significantly the 30-day and 6-month mortality. This series brought new important information, early mortality significantly increased because of underlying disease decompensation. Minimal comprehensive care should be maintained in all circumstances in order to avoid excess of mortality among elderly population with hip fractures. Public Library of Science 2022-02-25 /pmc/articles/PMC8880866/ /pubmed/35213561 http://dx.doi.org/10.1371/journal.pone.0263680 Text en © 2022 Boukebous et al https://creativecommons.org/licenses/by/4.0/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 author and source are credited.
spellingShingle Research Article
Boukebous, Baptiste
Maillot, Cédric
Neouze, Angèle
Esnault, Hélène
Gao, Fei
Biau, David
Rousseau, Marc-Antoine
Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center
title Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center
title_full Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center
title_fullStr Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center
title_full_unstemmed Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center
title_short Excess mortality after hip fracture during COVID-19 pandemic: More about disruption, less about virulence—Lesson from a trauma center
title_sort excess mortality after hip fracture during covid-19 pandemic: more about disruption, less about virulence—lesson from a trauma center
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880866/
https://www.ncbi.nlm.nih.gov/pubmed/35213561
http://dx.doi.org/10.1371/journal.pone.0263680
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