Egol Kenneth A, Konda Sanjit R, Bird Mackenzie L, Dedhia Nicket, Landes Emma K, Ranson Rachel A, Solasz Sara J, Aggarwal Vinay K, Bosco Joseph A, Furgiuele David L, Ganta Abhishek, Gould Jason, Lyon Thomas R, McLaurin Toni M, Tejwani Nirmal C, Zuckerman Joseph D, Leucht Philipp
Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY.
Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Richmond Hill, NY; and.
J Orthop Trauma. 2020 Aug;34(8):395-402. doi: 10.1097/BOT.0000000000001845.
To examine one health system's response to the essential care of its hip fracture population during the COVID-19 pandemic and report on its effect on patient outcomes.
Prospective cohort study.
Seven musculoskeletal care centers within New York City and Long Island.
PATIENTS/PARTICIPANTS: One hundred thirty-eight recent and 115 historical hip fracture patients.
Patients with hip fractures occurring between February 1, 2020, and April 15, 2020, or between February 1, 2019, and April 15, 2019, were prospectively enrolled in an orthopaedic trauma registry and chart reviewed for demographic and hospital quality measures. Patients with recent hip fractures were identified as COVID positive (C+), COVID suspected (Cs), or COVID negative (C-).
Hospital quality measures, inpatient complications, and mortality rates.
Seventeen (12.2%) patients were confirmed C+ by testing, and another 14 (10.1%) were suspected (Cs) of having had the virus but were never tested. The C+ cohort, when compared with Cs and C- cohorts, had an increased mortality rate (35.3% vs. 7.1% vs. 0.9%), increased length of hospital stay, a greater major complication rate, and a greater incidence of ventilator need postoperatively.
COVID-19 had a devastating effect on the care of patients with hip fracture during the pandemic. Although practice patterns generally remained unchanged, treating physicians need to understand the increased morbidity and mortality in patients with hip fracture complicated by COVID-19.
Prognostic Level III. See Instructions for Authors for a complete description of Levels of Evidence.
研究一个医疗系统在2019冠状病毒病大流行期间对髋部骨折患者基本护理的应对措施，并报告其对患者预后的影响。
前瞻性队列研究。
纽约市和长岛的七个肌肉骨骼护理中心。
患者/参与者：138例近期髋部骨折患者和115例既往髋部骨折患者。
前瞻性纳入2020年2月1日至2020年4月15日或2019年2月1日至2019年4月15日期间发生髋部骨折的患者，将其纳入骨科创伤登记系统，并查阅病历以获取人口统计学和医院质量指标。近期髋部骨折患者被确定为新冠病毒检测阳性（C+）、新冠病毒疑似感染（Cs）或新冠病毒检测阴性（C-）。
医院质量指标、住院并发症和死亡率。
17例（12.2%）患者检测确诊为C+，另有14例（10.1%）疑似感染新冠病毒但未进行检测。与Cs组和C-组相比，C+组死亡率更高（35.3%对7.1%对0.9%），住院时间更长，主要并发症发生率更高，术后呼吸机需求发生率更高。
2019冠状病毒病大流行期间，新冠病毒对髋部骨折患者的护理产生了毁灭性影响。尽管诊疗模式总体保持不变，但治疗医生需要了解新冠病毒感染合并髋部骨折患者发病率和死亡率的增加情况。
预后III级。有关证据水平的完整描述，请参阅作者指南。
