Risk of Mortality for Proximal Femoral Fracture in Patients With and Without COVID-19. A Retrospective Cohort Study.

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY Geriatric Orthopaedic Surgery & Rehabilitation Pub Date : 2022-11-10 eCollection Date: 2022-01-01 DOI:10.1177/21514593221138656

Ashley Holub, Montsant Jornet-Gibert, Jill Ruppenkamp, Chantal E Holy, Juan Daccach, Pere Torner, Pedro Caba-Doussoux, Josep Maria Muñoz Vives

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Abstract

Background: SARS-CoV-2 (COVID-19) has resulted in a widespread loss of lives, morbidity, and major disruptions to the healthcare system. Hip fractures are an emergent condition which require early intervention to reduce increased risk of mortality and morbidity. Infection of SARS-CoV-2 may contribute to increased mortality due to the role of infection and immune response. This study investigated the impact of COVID-19 infection (defined by clinical symptoms) on mortality following proximal femoral fracture (PFF) repair procedures.

Methods: This study was a retrospective cohort study. Data from the Premier Healthcare Database^® was extracted for patients presenting for PFF during 2019 for control, and February 2020-September 2020 to represent a COVID time-period.

Results: A total of N = 73 953 subjects were enrolled for the 2019 period, and a total of N = 34 842 subjects were enrolled for the COVID period. For the 2019 period, subjects who had a PFF procedure and who had flu/COVID-like illness had 2.47 (CI:2.11, 2.88) times the odds of mortality compared to those who did not have flu/COVID-like illness. Subjects who had a PFF procedure and who had flu/COVID-like illness during the COVID period had 2.85 times (CI:2.36, 3.42) the odds of mortality compared to those who did not have flu/COVID-like illness. For the COVID period, within subjects who did not have a PFF procedure, those with flu/COVID-like illness had increased odds of mortality compared to those who did not have flu/COVID-like illness (OR:2.26, CI:1.57, 3.21).

Conclusions: Hip fractures present high risk for mortality and morbidity, where timely intervention is critical to improved outcomes. Presence of infection such as flu/COVID-like illness may influence mortality in patients undergoing hip fracture repair procedures. Consideration of infection status as a comorbidity is important to proper management and achieving optimal outcomes.

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感染和不感染COVID-19患者股骨近端骨折的死亡率风险回顾性队列研究。

背景:SARS-CoV-2 (COVID-19)已造成广泛的生命损失和发病率，并对卫生保健系统造成重大破坏。髋部骨折是一种紧急情况，需要早期干预以降低死亡率和发病率的增加风险。由于感染和免疫反应的作用，SARS-CoV-2感染可能导致死亡率增加。本研究调查了COVID-19感染(由临床症状定义)对股骨近端骨折(PFF)修复手术后死亡率的影响。方法:本研究为回顾性队列研究。从Premier Healthcare Database®中提取2019年期间出现PFF的患者的数据作为对照，并从2020年2月至2020年9月期间提取数据以代表COVID时间段。结果:2019年共纳入N = 73 953名受试者，2019年新冠肺炎期间共纳入N = 34 842名受试者。在2019年期间，接受PFF手术并患有流感/ covid -样疾病的受试者的死亡率是没有流感/ covid -样疾病的受试者的2.47倍(CI:2.11, 2.88)。接受PFF手术并在COVID期间患有流感/COVID样疾病的受试者与未患有流感/COVID样疾病的受试者相比，死亡率为2.85倍(CI:2.36, 3.42)。在COVID期间，在未进行PFF手术的受试者中，与未患流感/COVID样疾病的受试者相比，患有流感/COVID样疾病的患者的死亡率增加(OR:2.26, CI:1.57, 3.21)。结论:髋部骨折具有较高的死亡率和发病率，及时干预对改善预后至关重要。感染，如流感/冠状病毒样疾病的存在可能会影响髋部骨折修复手术患者的死亡率。考虑感染状态作为合并症是重要的妥善管理和实现最佳结果。

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来源期刊

Geriatric Orthopaedic Surgery & Rehabilitation Medicine-Rehabilitation

CiteScore

3.00

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： Geriatric Orthopaedic Surgery & Rehabilitation (GOS) is an open access, peer-reviewed journal that provides clinical information concerning musculoskeletal conditions affecting the aging population. GOS focuses on care of geriatric orthopaedic patients and their subsequent rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE).