Amgen Canada Inc, Mississauga, ON, Canada.
Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada.
Arch Osteoporos. 2022 Aug 3;17(1):109. doi: 10.1007/s11657-022-01114-9.
Fragility fractures (i.e., low-energy fractures) account for most fractures among older Canadians and are associated with significant increases in morbidity and mortality. Study results suggest that low-energy fracture rates (associated with surgical intervention and outcomes) declined slightly, but largely remained stable in the first few months of the COVID-19 pandemic.
PURPOSE/INTRODUCTION: This study describes rates of low-energy fractures, time-to-surgery, complications, and deaths post-surgery in patients with fractures during the coronavirus disease (COVID-19) pandemic in Alberta, Canada, compared to the three years prior.
A repeated cross-sectional study was conducted using provincial-level administrative health data. Outcomes were assessed in 3-month periods in the 3 years preceding the COVID-19 pandemic and in the first two 3-month periods after restrictions were implemented. Patterns of fracture- and hospital-related outcomes over the control years (2017-2019) and COVID-19 restrictions periods (2020) were calculated.
Relative to the average from the control periods, there was a slight decrease in the absolute number of low-energy fractures (n = 4733 versus n = 4308) during the first COVID-19 period, followed by a slight rise in the second COVID-19 period (n = 4520 versus n = 4831). While the absolute number of patients with low-energy fractures receiving surgery within the same episode of care decreased slightly during the COVID-19 periods, the proportion receiving surgery and the proportion receiving surgery within 24 h of admission remained stable. Across all periods, hip fractures accounted for the majority of patients with low-energy fractures receiving surgery (range: 58.9-64.2%). Patients with complications following surgery and in-hospital deaths following fracture repair decreased slightly during the COVID-19 periods.
These results suggest that low-energy fracture rates, associated surgeries, and surgical outcomes declined slightly, but largely remained stable in the first few months of the pandemic. Further investigation is warranted to explore patterns during subsequent COVID-19 waves when the healthcare system experienced severe strain.
脆性骨折（即低能量骨折）是加拿大老年人中大多数骨折的原因，并与发病率和死亡率的显著增加有关。研究结果表明，低能量骨折发生率（与手术干预和结果相关）在 COVID-19 大流行的最初几个月略有下降，但基本保持稳定。
目的/介绍：本研究描述了在 COVID-19 大流行期间，与骨折相关的手术时间、并发症和术后死亡的发生率在加拿大艾伯塔省与 COVID-19 大流行前 3 年相比的情况。
使用省级行政健康数据进行重复横断面研究。在 COVID-19 大流行前 3 年的 3 个月期间和实施限制措施后的前两个 3 个月期间评估结果。在对照年（2017-2019 年）和 COVID-19 限制期（2020 年）期间计算骨折和医院相关结果的模式。
与对照期的平均值相比，在第一个 COVID-19 期间，低能量骨折的绝对数量略有下降（n=4733 与 n=4308），随后在第二个 COVID-19 期间略有上升（n=4520 与 n=4831）。虽然在 COVID-19 期间接受同一治疗期手术的低能量骨折患者的绝对数量略有下降，但接受手术的比例和入院后 24 小时内接受手术的比例保持稳定。在所有时期，髋部骨折占接受手术治疗的低能量骨折患者的大多数（范围：58.9-64.2%）。手术后并发症和骨折修复后住院死亡的患者数量在 COVID-19 期间略有下降。
这些结果表明，在大流行的最初几个月，低能量骨折发生率、相关手术和手术结果略有下降，但基本保持稳定。需要进一步调查，以探讨在医疗系统严重紧张的后续 COVID-19 浪潮期间的模式。
