Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom

J Orthop Trauma. 2020 Sep;34(9):e325-e329. doi: 10.1097/BOT.0000000000001889.

Abstract

Objectives: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom.

Methods: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from "day 0" of the COVID-19 pandemic in the United Kingdom and continued for 30 days. We collected data on time to surgery, Clinical Frailty Scale score, Nottingham Hip Fracture Score, COVID-19 infection status, 30-day mortality, and cause of death. For comparison, we collected retrospective data during the same 30-day period in 2018, 2019, and the previous 6 months (Control groups A, B, and C, respectively).

Results: Forty-three patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P = 0.022), B (P = 0.003) and C (P = 0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the 7 mortalities recorded, 4 patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P = 0.002, odds ratio 2.4).

Conclusions: Our study demonstrated a significant increase in 30-day mortality among hip fracture patients during the first 30 days of the COVID-19 pandemic in the United Kingdom. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality.

Level of evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Female
  • Fracture Fixation, Internal
  • Hip Fractures / complications
  • Hip Fractures / mortality*
  • Hip Fractures / surgery
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Prospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Survival Rate
  • Time Factors
  • United Kingdom