Jiménez-Telleria I, Urra I, Fernández-Gutiérrez L, Aragon E, Aguirre U, Foruria X, Moreta J
Servicio de Cirugía Ortopédica y Traumatología, Hospital de Galdakao-Usansolo, Bizkaia, España.
Servicio de Cirugía Ortopédica y Traumatología, Hospital de Galdakao-Usansolo, Bizkaia, España.
Rev Esp Cir Ortop Traumatol. 2022 Jul-Aug;66(4):T251-T259. doi: 10.1016/j.recot.2021.03.013. Epub 2022 Apr 27.
Compare 30-day mortality rate following a proximal femur fracture (PFF) and SARS-CoV-2 infection versus a PFF and no SARS-CoV-2 infection.
Retrospective comparative study.
Three university hospitals in Biscay province (Basque Country, Spain).
77 patients over 65 years-old with PFF (AO 31-A and 31-B).
Study conducted between 9 March and 15 April 2020. The COVID-19 group included only patients with SARS-CoV-2 infection, confirmed by a positive RT-PCR test.
30-Day mortality rate and risk factors for mortality.
Of a total 77 patients, 10 were diagnosed with SARS-CoV-2 infection. Mean age was 85 years. Patients with SARS-CoV-2 infection had higher BMI (29.53 kg/m) compared to patients without infection (24.09 kg/m) (p = 0.001). No significant differences were found between both groups in terms of the Charlson Comorbidity Index, ASA score, use of oral anticoagulants or presence of cognitive impairment. Seven of the 10 patients in the COVID-19 group developed (viral) pneumonia, as compared to one single case (1/67) of (bacterial) pneumonia in the control group (p < 0.001). Thirty-days mortality was higher (p = 0.03) in COVID-19 patients (40%) than in those in the control group (11.9%). In the multivariate analysis, age ≥ 91 years-old, ASA class IV and BMI > 25 kg/m were significant predictors of 30-day mortality. All deaths in the COVID-19 group occurred while the patients were hospitalized.
SARS-CoV-2 infection in patients with a PFF was seen to result in higher rates of early mortality, with COVID-19-related pneumonia being the leading direct cause of mortality.
Level III study.
比较股骨近端骨折（PFF）合并SARS-CoV-2感染与PFF但无SARS-CoV-2感染患者的30天死亡率。
回顾性比较研究。
比斯开省（西班牙巴斯克地区）的三家大学医院。
77例65岁以上的PFF患者（AO 31-A和31-B）。
研究于2020年3月9日至4月15日进行。COVID-19组仅包括经逆转录聚合酶链反应（RT-PCR）检测呈阳性确诊为SARS-CoV-2感染的患者。
30天死亡率和死亡危险因素。
77例患者中，10例被诊断为SARS-CoV-2感染。平均年龄为85岁。与未感染患者（24.09kg/m²）相比，SARS-CoV-2感染患者的体重指数（BMI）更高（29.53kg/m²）（p=0.001）。两组在Charlson合并症指数、美国麻醉医师协会（ASA）评分、口服抗凝剂的使用或认知障碍的存在方面均未发现显著差异。COVID-19组10例患者中有7例发生（病毒性）肺炎，而对照组仅有1例（1/67）（细菌性）肺炎（p<0.001）。COVID-19患者的30天死亡率（40%）高于对照组（11.9%）（p=0.03）。多因素分析显示，年龄≥91岁、ASA分级IV级和BMI>25kg/m²是30天死亡率的显著预测因素。COVID-19组所有死亡均发生在患者住院期间。
PFF患者感染SARS-CoV-2会导致更高的早期死亡率，与COVID-19相关的肺炎是主要的直接死亡原因。
III级研究。
