Perioperative mortality and morbidity of hip fractures among COVID-19 infected and non-infected patients: A systematic review and meta-analysis.
10.1016/j.cjtee.2021.05.004
- Author:
Sujit Kumar TRIPATHY
1
;
Paulson VARGHESE
2
;
Sibasish PANIGRAHI
2
;
Bijnya Birajita PANDA
3
;
Anand SRINIVASAN
4
;
Ramesh Kumar SEN
5
Author Information
1. Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India. Electronic address: sujitortho@aiimsbhubaneswar.edu.in.
2. Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India.
3. Department of Ophthalmology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, 753007, India.
4. Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, 751019, India.
5. Department of Orthopaedics, Max Hospital, Mohali, 160055, India.
- Publication Type:Journal Article
- Keywords:
COVID-19;
Femur neck fracture;
Hip fracture;
Mortality;
Pandemic
- MeSH:
Humans;
Aged;
COVID-19/epidemiology*;
Pandemics;
Hospital Mortality;
Hip Fractures/surgery*;
Pneumonia;
Morbidity;
Respiratory Insufficiency/complications*
- From:
Chinese Journal of Traumatology
2023;26(3):162-173
- CountryChina
- Language:English
-
Abstract:
PURPOSE:Hip fractures among elderly patients are surgical emergencies. During COVID-19 pandemic time, many such patients could not be operated at early time because of the limitation of the medical resources, the risk of infection and redirection of medical attention to a severe infective health problem.
METHODS:A search of electronic databases (PubMed, Medline, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials) with the keywords "COVID", "COVID-19″, "SARS-COV-2", "Corona", "pandemic", "hip fracture", "trochanteric fracture" and "neck femur fracture" revealed 64 studies evaluating treatment of hip fracture in elderly patients during COVID-19 pandemic time. The 30-day mortality rate, inpatient mortality rate, critical care/special care need, readmission rate and complications rate in both groups were evaluated. Data were analyzed using Review Manager (RevMan) V.5.3.
RESULTS:After screening, 7 studies were identified that described the mortality and morbidity in hip fractures in both COVID-19 infected (COVID-19 +) and non-infected (COVID-19 -) patients. There were significantly increased risks of 30-day mortality (32.23% COVID-19 + death vs. 8.85% COVID-19 - death) and inpatient mortality (29.33% vs. 2.62%) among COVID-19 + patients with odds ratio (OR) of 4.84 (95% CI: 3.13 - 7.47, p < 0.001) and 15.12 (95% CI: 6.12 - 37.37, p < 0.001), respectively. The COVID-19 + patients needed more critical care admission (OR = 5.08, 95% CI: 1.49 - 17.30, p < 0.009) and they remain admitted for a longer time in hospital (mean difference = 3.6, 95% CI: 1.74 - 5.45, p < 0.001); but there was no difference in readmission rate between these 2 groups. The risks of overall complications (OR = 17.22), development of pneumonia (OR = 22.25), and acute respiratory distress syndrome/acute respiratory failure (OR = 32.96) were significantly high among COVID-19 + patients compared to COVID-19 - patients.
CONCLUSIONS:There are increased risks of the 30-day mortality, inpatient mortality and critical care admission among hip fracture patients who are COVID-19 +. The chances of developing pneumonia and acute respiratory failure are more in COVID-19 + patients than in COVID-19 ‒ patients.
