The Countess of Chester NHS Foundation Trust, Chester, UK.
Macclesfield District General Hospital, Macclesfield, UK.
Bone Joint J. 2021 Apr;103-B(4):782-787. doi: 10.1302/0301-620X.103B.BJJ-2020-1862.R1. Epub 2021 Jan 28.
Despite the COVID-19 pandemic, incidence of hip fracture has not changed. Evidence has shown increased mortality rates associated with COVID-19 infection. However, little is known about the outcomes of COVID-19 negative patients in a pandemic environment. In addition, the impact of vitamin D levels on mortality in COVID-19 hip fracture patients has yet to be determined.
This multicentre observational study included 1,633 patients who sustained a hip fracture across nine hospital trusts in North West England. Data were collected for three months from March 2020 and for the same period in 2019. Patients were matched by Nottingham Hip Fracture Score (NHFS), hospital, and fracture type. We looked at the mortality outcomes of COVID-19 positive and COVID-19 negative patients sustaining a hip fracture. We also looked to see if vitamin D levels had an impact on mortality.
The demographics of the 2019 and 2020 groups were similar, with a slight increase in proportion of male patients in the 2020 group. The 30-day mortality was 35.6% in COVID-19 positive patients and 7.8% in the COVID-19 negative patients. There was a potential association of decreasing vitamin D levels and increasing mortality rates for COVID-19 positive patients although our findings did not reach statistical significance.
In 2020 there was a significant increase in 30-day mortality rates of patients who were COVID-19 positive but not of patients who were COVID-19 negative. Low levels of vitamin D may be associated with high mortality rates in COVID-19 positive patients. Cite this article: 2021;103-B(4):782-787.
尽管发生了 COVID-19 大流行，但髋部骨折的发病率并未改变。有证据表明，COVID-19 感染与死亡率升高有关。然而，在大流行环境下，对于 COVID-19 阴性患者的结局知之甚少。此外，维生素 D 水平对 COVID-19 髋部骨折患者死亡率的影响仍有待确定。
这项多中心观察性研究纳入了 2020 年 3 月至 9 家位于英格兰西北部的医院信托基金中发生髋部骨折的 1633 例患者。数据收集时间为 3 个月，2020 年的数据收集时间与 2019 年相同。通过诺丁汉髋部骨折评分（NHFS）、医院和骨折类型对患者进行匹配。我们观察了 COVID-19 阳性和 COVID-19 阴性髋部骨折患者的死亡率结局。我们还观察了维生素 D 水平是否对死亡率有影响。
2019 年和 2020 年组的人口统计学特征相似，2020 年组男性患者的比例略有增加。COVID-19 阳性患者的 30 天死亡率为 35.6%，COVID-19 阴性患者的死亡率为 7.8%。尽管我们的研究结果尚未达到统计学意义，但 COVID-19 阳性患者维生素 D 水平降低与死亡率升高之间存在潜在关联。
2020 年 COVID-19 阳性患者的 30 天死亡率显著升高，但 COVID-19 阴性患者的死亡率没有升高。维生素 D 水平较低可能与 COVID-19 阳性患者的高死亡率有关。
