The Impact of COVID-19 on Neck of Femur Fracture Care: A Major Trauma Centre Experience, United Kingdom | ||
The Archives of Bone and Joint Surgery | ||
مقاله 16، دوره 9، شماره 4، مهر و آبان 2021، صفحه 453-460 اصل مقاله (446.32 K) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2020.50429.2502 | ||
نویسندگان | ||
Jiang An Lim* 1؛ Azeem Thahir2؛ Vinayak Amar Korde3؛ Matija Krkovic2 | ||
11 Department of Trauma and Orthopeadics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom 2 School of Clinical Medicine, University Of Cambridge, Cambridge, United Kingdom | ||
2Department of Trauma and Orthopeadics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom | ||
3Department of Trauma and Orthopeadics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom- Department of Orthogeriatrics, Addenbrookes Hospital, United Kingdom | ||
چکیده | ||
Background: The aim of this study was to investigate the impact of the COVID-19 pandemic on the management and outcome of patients with neck of femur fractures. Methods: Data was collected for 96 patients with neck of femur fractures who presented to the emergency department between March 1, 2020 and May 15, 2020. This data set included information about their COVID-19 status. Parameters including inpatient complications, hospital quality measures, mortality rates, and training opportunities were compared between the COVID-19 positive and COVID-19 negative groups. Furthermore, our current cohort of patients were compared against a historical control group of 95 patients who presented with neck of femur fractures before the COVID-19 pandemic. Results: Seven (7.3%) patients were confirmed COVID positive by RT-PCR testing. The COVID positive cohort, when compared to the COVID negative cohort, had higher rates of postoperative complications (71.4% vs 25.9%), increased length of stay (30.3 days vs 12 days) and quicker time to surgery (0.7 days vs 1.3 days). The 2020 cohort compared to the 2019 cohort, had an increased 30-day mortality rate (13.5% vs 4.2%), increased number of delayed cases (25% vs 11.8%) as well as reduced training opportunities for Orthopaedic trainees to perform the surgery (51.6% vs 22.8%). Conclusion: COVID-19 has had a profound impact on the care and outcome of neck of femur fracture patients during the pandemic with an increase in 30-day mortality rate. There were profound adverse effects on patient management pathways and outcomes while also affecting training opportunities. Level of evidence: VI | ||
کلیدواژهها | ||
Coronavirus؛ COVID-19؛ Hip fracture؛ Neck of femur fracture؛ SARS-CoV-2 | ||
مراجع | ||
1. Varacallo M, Seaman TJ, Jandu JS, Pizzutillo P. Osteopenia. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC.; 2020. 2. Porter JL, Varacallo M. Osteoporosis. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC.; 2020. 3. Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018;49(8):1458-60. 4. Crist BD, Eastman J, Lee MA, Ferguson TA, Finkemeier CG. Femoral Neck Fractures in Young Patients. Instr Course Lect. 2018;67:37-49. 5. Mao R, Liang J, Shen J, Ghosh S, Zhu LR, Yang H, et al. Implications of COVID-19 for patients with preexisting digestive diseases. Lancet Gastroenterol Hepatol. 2020;5(5):425-7. 6. WHO. Coronavirus disease (COVID-19) pandemic 2020 [Available from: https://www.who.int/emergencies/ diseases/novel-coronavirus-2019. 7. Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M, et al. Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. Lancet Respir Med. 2020;8(5):518-26. 8. Awad ME, Rumley JCL, Vazquez JA, Devine JG. Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed COVID-19 Orthopaedic Patients: Operating Room Protocols and Recommendations in the Current COVID-19 Pandemic. J Am Acad Orthop Surg. 2020;28(11):451-63. 9. DePhillipo NN, Larson CM, O’Neill OR, LaPrade RF. Guidelines for Ambulatory Surgery Centers for the Care of Surgically Necessary/Time-Sensitive Orthopaedic Cases During the COVID-19 Pandemic. J Bone Joint Surg Am. 2020;102(11):933-6. 10. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9. 11. Baker T, Schell CO, Petersen DB, Sawe H, Khalid K, Mndolo S, et al. Essential care of critical illness must not be forgotten in the COVID-19 pandemic. Lancet (London, England). 2020;395(10232):1253-4. 12. Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-e8. 13. Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21:100331. 14. Aminian A, Safari S, Razeghian-Jahromi A, Ghorbani M, Delaney CP. COVID-19 Outbreak and Surgical Practice: Unexpected Fatality in Perioperative Period. Ann Surg. 2020. 15. Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020;20(6):363-74. 16. Zhang W, Zhao Y, Zhang F, Wang Q, Li T, Liu Z, et al. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China. Clin Immunol. 2020;214:108393. 17. Kuo CL, Pilling LC, Atkins JL, Masoli JAH, Delgado J, Kuchel GA, et al. APOE e4 genotype predicts severe COVID-19 in the UK Biobank community cohort. J Gerontol A Biol Sci Med Sci. 2020. 18. BOAST. Management of patients with urgent orthopaedic conditions and trauma during the coronavirus pandemic 2020 [Available from: https://www.boa.ac.uk/resources/covid-19-boastscombined. html. 19. Delgado A, Cordero GGE, Marcos S, Cordero-Ampuero J. Influence of cognitive impairment on mortality, complications and functional outcome after hip fracture: Dementia as a risk factor for sepsis and urinary infection. Injury. 2020;51 Suppl 1:S19-s24. 20. BGS. Managing Hip Fractures during COVID19 2020 [Available from: https://www.bgs.org.uk/blog/ managing-hip-fractures-during-covid19. 21. Pincus D, Ravi B, Wasserstein D, Huang A, Paterson JM, Nathens AB, et al. Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery. Jama. 2017;318(20):1994-2003. 22. Muñoz Vives JM, Jornet-Gibert M, Cámara-Cabrera J, Esteban PL, Brunet L, Delgado-Flores L, et al. Mortality Rates of Patients with Proximal Femoral Fracture in a Worldwide Pandemic: Preliminary Results of the Spanish HIP-COVID Observational Study. J Bone Joint Surg Am. 2020. 23. Egol KA, Konda SR, Bird ML, Dedhia N, Landes EK, Ranson RA, et al. Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective. Journal of Orthopaedic Trauma. 2020;Publish Ahead of Print. 24. Morrissey N, Iliopoulos E, Osmani AW, Newman K. Neck of femur fractures in the elderly: Does every hour to surgery count? Injury. 2017;48(6):1155-8. 25. RCS. COVID-19: Good Practice for Surgeons and Surgical Teams 2020 [Available from] https://www. rcseng.ac.uk/standards-and-research/standardsand- guidance/good-practice-guides/coronavirus/ covid-19-good-practice-for-surgeons-and-surgicalteams/. | ||
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