Hip fracture care during the 2020 COVID-19 first-wave: a review of the outcomes of hip fracture patients at a Scottish Major Trauma Centre.

Autor: Greensmith TSW; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK. Electronic address: sam.greensmith@nhs.scot., Faulkner AC; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK., Davies PSE; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK., Sinnerton RJH; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK., Cherry JV; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK., Supparamaniam S; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK., MacInnes A; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK., Dalgleish S; Department of Trauma and Orthopaedics, Ninewells Hospital, NHS Tayside, Dundee, DD1 9SY, UK.
Jazyk: angličtina
Zdroj: The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland [Surgeon] 2021 Oct; Vol. 19 (5), pp. e318-e324. Date of Electronic Publication: 2021 Feb 25.
DOI: 10.1016/j.surge.2021.01.012
Abstrakt: Background and Purpose of the Study: This study reviewed whether the response to the Coronavirus (COVID-19) pandemic affected the care for hip fracture patients at a major trauma centre in Scotland during the first-wave lock-down period.
Methods: All patients referred to Orthopaedics with a hip fracture in a major trauma centre in Scotland were captured between 14 th March and 28 th May (11 weeks) in 2020 and 2019. Patients were identified using electronic patient records. The primary outcomes are time to theatre, length of admission and 30-day mortality. Secondary outcomes are COVID-19 prevalence, duration of surgery, proportion of patients to theatre within 36 hours and COVID-19 positive 30-day mortality from time of surgery. 225 patients were included: 108 from 2019 and 117 from 2020.
The Main Findings: 30-day mortality was 3.7% (n=4) in 2019 and 8.5% (n=10) in 2020 (p=0.142). There was no statistical difference with time to theatre (p=0.150) nor duration of theatre (p=0.450). Duration of admission was reduced from 12 days to 6.5 days (p=<0.005). 4 patients tested positive for COVID-19 during admission, one 5 days after discharge, all underwent surgical management. 30-day mortality for COVID-19 positive patients during admission was 40%. COVID-19 prevalence of patients that were tested (n=89) was 5.62%.
Conclusions: This study has shown the care of hip fracture patients has been maintained during the COVID-19 pandemic. There is no statistically significant change in mortality, time to theatre, and duration of surgery, however, the patient's admission duration was significantly less than the 2019 cohort.
Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest to declare.
(Copyright © 2021 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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