Serra-Torres Michael, Barreda Raul, Weaver David, Torres-Reveron Annelyn
DHR Health Orthopedic Institute, Edinburg, TX 78539, USA.
DHR Health Institute for Research and Development, Edinburg, TX 78539, USA.
Adv Orthop. 2021 Feb 16;2021:8822004. doi: 10.1155/2021/8822004. eCollection 2021.
To evaluate the effects of COVID-19 and stay-at-home orders in traumatic hip fractures presentation, we conducted a retrospective chart review cohort study from March 13 to June 13 in 2020 compared to 2019 from a single-hospital Trauma Level 2 Center. Males and females, 18 years of age and older presenting with a diagnosis of displaced or nondisplaced, intracapsular, or extracapsular hip fracture, underwent standard of care-comparative analysis of the patient's characteristics and clinical outcomes. The primary study outcomes included age, sex, ethnicity, and body mass index, the onset of injury, date of arrival, payer, the primary type of injury and comorbidities, mechanism of injury, treatment received, postoperative complications, days in an intensive care unit (ICU), discharge disposition, pre- and postinjury functional status, and COVID-19 test. Age, sex, ethnicity, and body mass index were similar in the patients in 2019 compared to 2020. The patients' average age was 76 years old, 80% reported Hispanic ethnicity, and 63% of the patients were females. Most injuries (90%) occurred due to falls. On average, patients in 2020 presented 4.8 days after the injury onset as compared to 0.7 days in 2019 ( < 0.05). There was an increase in displaced fractures in 2019 compared to 2020 and an increase in patients' disposition into rehabilitation facilities compared to skilled nursing facilities. Despite the delay in presentation, length of stay, days in the ICU, or functional outcomes of the patients were not affected. Although the patients showed a delayed presentation after hip fracture, this does not appear to significantly interfere with the short-term or the 6-month mortality outcomes of the patients, suggesting the possibility of guided delayed care during times of national emergency and increased strain in hospital resources.
为评估2019冠状病毒病（COVID-19）和居家令对创伤性髋部骨折就诊情况的影响，我们在一家二级创伤中心开展了一项回顾性图表审查队列研究，比较了2020年3月13日至6月13日与2019年同期的情况。年龄在18岁及以上、诊断为移位或未移位、囊内或囊外髋部骨折的男性和女性患者，接受了患者特征和临床结局的标准对照分析。主要研究结局包括年龄、性别、种族、体重指数、受伤时间、到达日期、付款人、主要损伤类型和合并症、损伤机制、接受的治疗、术后并发症、重症监护病房（ICU）住院天数、出院处置、伤前和伤后功能状态以及COVID-19检测。与2020年相比，2019年患者的年龄、性别、种族和体重指数相似。患者的平均年龄为76岁，80%报告为西班牙裔，63%为女性。大多数损伤（90%）是由跌倒引起的。2020年患者平均在受伤后4.8天就诊，而2019年为0.7天（P<0.05）。与2020年相比，2019年移位骨折有所增加，与熟练护理机构相比，进入康复机构的患者有所增加。尽管就诊延迟，但患者的住院时间、ICU住院天数或功能结局并未受到影响。虽然患者髋部骨折后就诊延迟，但这似乎并未显著干扰患者的短期或6个月死亡率结局，这表明在国家紧急情况和医院资源紧张加剧期间，有可能进行有指导的延迟护理。
