Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, 301 E 17Th St, New York, NY, 10010, USA.
Department of Orthopedic Surgery, Jamaica Hospital Medical Center, 8900 Van Wyck Expy, Richmond Hill, NY, 11418, USA.
Musculoskelet Surg. 2023 Dec;107(4):405-412. doi: 10.1007/s12306-023-00784-z. Epub 2023 Apr 5.
The purpose of this study was to assess the impact of COVID-19 on long-term outcomes in the geriatric hip fracture population. We hypothesize that COVID + geriatric hip fracture patients had worse outcomes at 1-year follow-up. Between February and June 2020, 224 patients > 55 years old treated for a hip fracture were analyzed for demographics, COVID status on admission, hospital quality measures, 30- and 90-day readmission rates, 1-year functional outcomes (as measured by the EuroQol- 5 Dimension [EQ5D-3L] questionnaire), and inpatient, 30-day, and 1-year mortality rates with time to death. Comparative analyses were conducted between COVID + and COVID- patients. Twenty-four patients (11%) were COVID + on admission. No demographic differences were seen between cohorts. COVID + patients experienced a longer length of stay (8.58 ± 6.51 vs. 5.33 ± 3.09, p < 0.01) and higher rates of inpatient (20.83% vs. 1.00%, p < 0.01), 30-day (25.00% vs. 5.00%, p < 0.01), and 1-year mortality (58.33% vs. 18.50%, p < 0.01). There were no differences seen in 30- or 90-day readmission rates, or 1-year functional outcomes. While not significant, COVID + patients had a shorter average time to death post-hospital discharge (56.14 ± 54.31 vs 100.68 ± 62.12, p = 0.171). Pre-vaccine, COVID + geriatric hip fracture patients experienced significantly higher rates of mortality within 1 year post-hospital discharge. However, COVID + patients who did not die experienced a similar return of function by 1-year as the COVID- cohort.
本研究旨在评估 COVID-19 对老年髋部骨折患者的长期预后的影响。我们假设 COVID 阳性+老年髋部骨折患者在 1 年随访时的结局更差。在 2020 年 2 月至 6 月期间，对 224 名年龄>55 岁接受髋部骨折治疗的患者进行了分析，内容包括人口统计学资料、入院时的 COVID 状态、医院质量指标、30 天和 90 天再入院率、1 年功能结局（采用 EuroQol-5 维度[EQ5D-3L]问卷进行测量）以及住院、30 天和 1 年死亡率和死亡时间。对 COVID 阳性+患者和 COVID-患者进行了比较分析。24 名患者（11%）入院时 COVID 阳性。两组患者的人口统计学特征无差异。COVID 阳性患者的住院时间更长（8.58±6.51 与 5.33±3.09，p<0.01），住院（20.83%与 1.00%，p<0.01）、30 天（25.00%与 5.00%，p<0.01）和 1 年死亡率（58.33%与 18.50%，p<0.01）更高。30 天和 90 天再入院率以及 1 年功能结局无差异。虽然无统计学意义，但 COVID 阳性患者出院后平均死亡时间更短（56.14±54.31 与 100.68±62.12，p=0.171）。在疫苗接种前，COVID 阳性老年髋部骨折患者在出院后 1 年内的死亡率显著更高。然而，未死亡的 COVID 阳性患者在 1 年时的功能恢复与 COVID-组相似。
