Shah Faisal Younis, Gill Jaskiran, Sheikh Hamza, Tross Samantha
Ealing Hospital, Londres, Reino Unido.
Rev Bras Ortop (Sao Paulo). 2021 Mar 31;56(5):594-600. doi: 10.1055/s-0041-1726063. eCollection 2021 Oct.
We are doing a study on patients admitted with hip fractures to determine the impact of COVID-19 on a vulnerable patients group in the United Kingdom. This will help us in making informed decisions about restarting elective surgical services and expanding trauma surgical services. The objectives of the study are: 1) to find the incidence of COVID-19 in patients admitted with hip fractures; 2) To find the 30-day mortality in patients operated with hip fractures; 3) To find the 30-day mortality of patients with hip fracture and COVID 19; and 4) to compare this data with the mortality in hip fractures in previous years. This is a single-center, observational, retrospective, cohort study involving 65 patients who were admitted in our trust with hip fractures. Besides epidemiological data, patient records were followed-up for 14 days to look for COVID positive polymerase chain reaction (PCR) swabs, and the patient records were followed-up for 30 days to look for mortality. A total of 64% of the patients had no significant comorbidity. The incidence of hospital-acquired COVID-19 infections in our trust was 9%. Overall, the 30-day mortality was of 15%. Mortality was much higher in COVID positive patients (40%) and in patients with "very high risk" (63%) operated during this period. It should be safe to start elective surgery in patients with low, moderate and high risk without an appreciable rise in mortality. We will need more data to understand the impact of COVID-19 on very high risk patients.
我们正在对因髋部骨折入院的患者进行一项研究,以确定新冠病毒病对英国弱势群体的影响。这将有助于我们就是否重启择期手术服务及扩大创伤外科服务做出明智决策。本研究的目的是:1)确定因髋部骨折入院患者中新冠病毒病的发病率;2)确定接受髋部骨折手术患者的30天死亡率;3)确定髋部骨折合并新冠病毒病患者的30天死亡率;4)将这些数据与前几年髋部骨折患者的死亡率进行比较。 这是一项单中心、观察性、回顾性队列研究,涉及65名因髋部骨折入住我们信托医院的患者。除了流行病学数据外,对患者记录进行了14天的随访,以查找新冠病毒核酸检测阳性拭子,并对患者记录进行了30天的随访,以查找死亡情况。 共有64%的患者无明显合并症。我们信托医院医院获得性新冠病毒病感染率为9%。总体而言,30天死亡率为15%。在此期间接受手术的新冠病毒核酸检测阳性患者(40%)和“极高风险”患者(63%)的死亡率要高得多。 对于低风险、中风险和高风险患者,开始择期手术应该是安全的,死亡率不会显著上升。我们需要更多数据来了解新冠病毒病对极高风险患者的影响。