Author:
Raheman Firas J.,Rojoa Djamila M.,Nayan Parekh Jvalant,Berber Reshid,Ashford Robert
Abstract
AbstractIncidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.
Publisher
Springer Science and Business Media LLC
Reference63 articles.
1. Coronavirus Disease (COVID-19)—events as they happen. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen. Accessed 23 Dec 2020.
2. Schattner, A. The Burden of Hip Fractures-Why Aren’t We Better at Prevention? Vol. 111, 765–767 (QJM Oxford University Press, 2018).
3. Ettinger, B., Black, D. M., Dawson-Hughes, B., Pressman, A. R. & Melton, L. J. Updated fracture incidence rates for the US version of FRAX®. Osteoporos Int. 21, 25–33 (2010).
4. Scott, C. E. H. et al. Population mobility and adult orthopaedic trauma services during the COVID-19 pandemic: Fragility fracture provision remains a priority. Bone Jt. Open. 1(6), 182–189 (2020).
5. Nuñez, J. H. et al. Impact of the COVID-19 pandemic on an emergency traumatology service: Experience at a tertiary trauma centre in Spain. Injury 51(7), 1414–1418 (2020).
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