Tripathy Sujit Kumar, Varghese Paulson, Panigrahi Sibasish, Panda Bijnya Birajita, Velagada Sandeep, Sahoo Samrat Smrutiranjan, Naik Monappa A, Rao Sharath K
Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar 751019, India.
Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, India.
World J Orthop. 2021 Jan 18;12(1):35-50. doi: 10.5312/wjo.v12.i1.35.
Timely intervention in hip fracture is essential to decrease the risks of perioperative morbidity and mortality. However, limitations of the resources, risk of disease transmission and redirection of medical attention to a more severe infective health problem during coronavirus disease 2019 (COVID-19) pandemic period have affected the quality of care even in a surgical emergency.
To compare the 30-d mortality rate and complications of hip fracture patients treated during COVID-19 pandemic and pre-pandemic times.
The search of electronic databases on 1 August 2020 revealed 45 studies related to mortality of hip fracture during the COVID-19 pandemic and pre-pandemic times. After careful screening, eight studies were eligible for quantitative and qualitative analysis of data.
The pooled data of eight studies ( = 1586) revealed no significant difference in 30-d mortality rate between the hip fracture patients treated during the pandemic and pre-pandemic periods [9.63% 6.33%; odds ratio (OR), 0.62; 95%CI, 0.33, 1.17; = 0.14]. Even the 30-d mortality rate was not different between COVID-19 non-infected patients who were treated during the pandemic time, and all hip fracture patients treated during the pre-pandemic period (OR, 1.03; 95%CI, 0.61, 1.75; = 0.91). A significant difference in mortality rate was observed between COVID-19 positive and COVID-19 negative patients (OR, 6.99; 95%CI, 3.45, 14.16; < 0.00001). There was no difference in the duration of hospital stay (OR, -1.52, 95%CI, -3.85, 0.81; = 0.20), overall complications (OR, 1.62; = 0.15) and incidence of pulmonary complications (OR, 1.46; = 0.38) in these two-time frames. Nevertheless, the preoperative morbidity was more severe, and there was less use of general anesthesia during the pandemic time.
There was no difference in 30-d mortality rate between hip fracture patients treated during the pandemic and pre-pandemic periods. However, the mortality risk was higher in COVID-19 positive patients compared to COVID-19 negative patients. There was no difference in time to surgery, complications and hospitalization time between these two time periods.
对髋部骨折进行及时干预对于降低围手术期发病率和死亡率风险至关重要。然而，在2019冠状病毒病（COVID-19）大流行期间，资源有限、疾病传播风险以及医疗资源转向更严重的感染性健康问题，即使在外科急症情况下也影响了医疗质量。
比较COVID-19大流行期间和大流行前接受治疗的髋部骨折患者的30天死亡率和并发症情况。
2020年8月1日对电子数据库进行检索，发现45项与COVID-19大流行期间和大流行前髋部骨折死亡率相关的研究。经过仔细筛选，8项研究符合数据定量和定性分析的条件。
8项研究（n = 1586）的汇总数据显示，大流行期间和大流行前接受治疗的髋部骨折患者的30天死亡率无显著差异[9.63%对6.33%；优势比（OR），0.62；95%置信区间（CI），0.33，1.17；P = 0.14]。即使在大流行期间接受治疗的COVID-19未感染患者与大流行前接受治疗的所有髋部骨折患者之间，30天死亡率也没有差异（OR，1.03；95%CI，0.61，1.75；P = 0.91）。观察到COVID-19阳性和COVID-19阴性患者之间的死亡率存在显著差异（OR，6.99；95%CI，3.45，14.16；P < 0.00001）。在这两个时间段内，住院时间（OR，-1.52，95%CI，-3.85，0.81；P = 0.20）、总体并发症（OR，1.62；P = 0.15）和肺部并发症发生率（OR，1.46；P = 0.38）没有差异。然而，大流行期间术前发病率更严重，全身麻醉的使用也更少。
大流行期间和大流行前接受治疗的髋部骨折患者的30天死亡率没有差异。然而，与COVID-19阴性患者相比，COVID-19阳性患者的死亡风险更高。这两个时间段之间的手术时间、并发症和住院时间没有差异。
