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Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology
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Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology
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Journal Article
Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology
2020
Overview
Purpose
To analyse the impact of prolonged mandatory lockdown due to COVID-19 on hip fracture epidemiology.
Methods
Retrospective case-control study of 160 hip fractures operated upon between December 2019 and May 2020. Based on the date of declaration of national lockdown, the cohort was separated into two groups: ‘pre-COVID time’ (PCT), including 86 patients, and ‘COVID time’ (CT), consisting of 74 patients. All CT patients tested negative for SARS-CoV-2. Patients were stratified based on demographic characteristics. Outcome measures were 30-day complications, readmissions and mortality. A logistic regression model was run to evaluate factors associated with mortality.
Results
Age, female/male ratio, body mass index and American Society of Anaesthesia score were similar between both groups (
p
> 0.05). CT patients had a higher percentage of Charlson ≥ 5 and Rockwood Frailty Index ≥ 5 scores (
p
< 0.05) as well as lower UCLA and Instrumental Activities of Daily Living scores (
p
< 0.05). This translated into a higher hemiarthroplasty/total hip arthroplasty ratio during CT (
p
= 0.04). Thromboembolic disease was higher during CT (
p
= 0.02). Readmissions (all negative for SARS-CoV-2) were similar between both groups (
p
= 0.34). Eight (10.8%) casualties were detected in the CT group, whereas no deaths were seen in the control group. Logistic regression showed that frailer (
p
= 0.006, OR 10.46, 95%CI 8.95–16.1), less active (
p
= 0.018, OR 2.45, 95%CI 1.45–2.72) and those with a thromboembolic event (
p
= 0.005, OR 30, 95%CI 11–42) had a higher risk of mortality.
Conclusion
Despite testing negative for SARS-CoV-2, CT patients were less active and frailer than PCT patients, depicting an epidemiological shift that was associated with higher mortality rate.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
