Popp Domenik, Nia Arastoo, Silvaieh Sara, Sator Thomas, Tiefenboeck Thomas M, Schmoelz Lukas, Babeluk Rita, Hajdu Stefan, Widhalm Harald K
Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.
Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria.
Healthcare (Basel). 2023 Dec 7;11(24):3110. doi: 10.3390/healthcare11243110.
The COVID-19 pandemic has had a significant impact on the treatment protocols of orthopedic and trauma departments, but its specific effect on the mortality of hip fracture patients due to possible delays in surgery remains uncertain. This study aimed to investigate whether the COVID-19 pandemic worsened the mortality of patients with hip fractures.
This study included 246 prospectively enrolled patients who suffered from hip fractures during the Austrian State of Emergency period between 1 March and 30 June 2020 and 2021 and were admitted to a tertiary care trauma center. This cohort was compared with a retrospective control group of 494 patients admitted for hip fractures during the same timeframe in 2017, 2018, and 2019. These groups were compared to a prospective recruited "post-COVID-19 collective consisting of the years 2022 and 2023 including 313 patients.
This study found a 22% reduction in admissions during the COVID-19 period compared to the pre-COVID period ( = 0.018), as well as significant changes in gender ( = 0.013) and place of accident ( = 0.049). No other changes in demographic variables were observed. The 30-day mortality rate was 14.67% in the pre-COVID period, compared to 15.18% during the COVID-19 period ( = 0.381). No differences were observed in surgical complication rates or in the relationship between comorbidity burden and survival.
This study did not show a higher perioperative mortality rate due to COVID-19. However, under current circumstances, with potentially reduced surgical and hospital bed capacities, it is expected that this condition might require a high degree of resources in times when resources are potentially scarce, such as during an ongoing pandemic.
Level III.
新冠疫情对骨科和创伤科的治疗方案产生了重大影响，但其因手术可能延迟对髋部骨折患者死亡率的具体影响仍不确定。本研究旨在调查新冠疫情是否会使髋部骨折患者的死亡率恶化。
本研究纳入了246例前瞻性招募的患者，这些患者在2020年3月1日至6月30日以及2021年奥地利紧急状态期间因髋部骨折入院，并被收治于一家三级创伤中心。该队列与2017年、2018年和2019年同一时间段因髋部骨折入院的494例患者的回顾性对照组进行比较。这些组与2022年和2023年前瞻性招募的“新冠后群体”（包括313例患者）进行比较。
本研究发现，与新冠疫情前相比，新冠疫情期间入院人数减少了22%（P = 0.018），性别（P = 0.013）和事故发生地点（P = 0.049）也有显著变化。未观察到人口统计学变量的其他变化。新冠疫情前30天死亡率为14.67%，而新冠疫情期间为15.18%（P = 0.381）。手术并发症发生率或合并症负担与生存率之间的关系未观察到差异。
本研究未显示新冠疫情导致围手术期死亡率升高。然而，在当前情况下，手术和医院床位容量可能减少，预计在资源可能稀缺的时期，如正在发生疫情期间，这种情况可能需要大量资源。
三级。
