Santos Diego DA Silva, Barros Edivando Moura, Hosni Nicole Dittrich, Scatigna Bruno Francesco, Falótico Guilherme Guadagnini, Takata Edmilson Takehiro
Universidade Federal de São Paulo, Paulista School of Medicine, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.
Acta Ortop Bras. 2022 Nov 11;30(5):e255298. doi: 10.1590/1413-785220223005e255298. eCollection 2022.
To evaluate the impact of the COVID-19 pandemic on hospital admission and mortality indicators in older adults with fractures of the proximal femur.
Observational and retrospective study that took place from June 2016 to 2020. Patients of both genders who underwent surgical treatment for fractures of the proximal end of the femur, aged over 60 years, were included.
The population consisted of 379 patients, treated before (group 1; N = 278; 73.35%) and during the pandemic (group 2; N = 101; 26.65%). Higher mortality was observed in group 2 (N = 24; 23.8%) versus group 1 (N = 10; 3.6%), p < 0.001. The highest proportion of deaths in group 2 was maintained in patients aged 70-79 years (p = 0.011), 80-89 years (p ≤ 0.001) and > 90 years (p ≤ 0.001). In addition, the preoperative time and hospital stay were longer in group 2 compared to group 1 (p ≤ 0.001).
The present study demonstrated that the pandemic period increased the mortality rate and the preoperative and hospitalization time in older patients with femur fractures. Thus, the pandemic has affected the care of fractures of the proximal femur in older adults, which reinforces the need to adopt measures to reduce complications and mortality.
评估2019冠状病毒病(COVID-19)大流行对老年股骨近端骨折患者住院及死亡率指标的影响。
本研究为2016年6月至2020年进行的观察性回顾性研究。纳入年龄超过60岁、接受股骨近端骨折手术治疗的男女患者。
研究对象共379例患者,其中在大流行之前接受治疗的为第1组(n = 278;73.35%),在大流行期间接受治疗的为第2组(n = 101;26.65%)。第2组的死亡率(n = 24;23.8%)高于第1组(n = 10;3.6%),p < 0.001。第2组中,70 - 79岁(p = 0.011)、80 - 89岁(p ≤ 0.001)和90岁以上(p ≤ 0.001)患者的死亡比例最高。此外,与第1组相比,第2组的术前时间和住院时间更长(p ≤ 0.001)。
本研究表明,大流行期间老年股骨骨折患者的死亡率以及术前和住院时间均有所增加。因此,大流行影响了老年股骨近端骨折的治疗,这进一步强调了采取措施减少并发症和死亡率的必要性。