Mortality Increase after Hip Fracture in Aged Patients during the First 6 Months of the COVID-19 Epidemic

Background: The COVID-19 pandemic modified hospital functioning, social mobility and assistance to the elderly. These factors may alter hip fracture evolution.Methods: Retrospective study of patients > 65 years suffering hip fracture from the 1st of March to the 31st of August of 2020, and compared with patients from the same period of 2019; 199 patients from 2019 (79.4% women) (mean age: 84.9 +/- 7.72 years), and 203 patients from 2020 (69.5% women) (mean age: 85.37 +/- 8.13 years). Extracapsular fractures were 57.3% in 2019, and 58.6% in 2020. Follow-up was made until death or 6 months after surgery.Results: In 2019,44 patients (22.1%) died in the six postoperative months, and 61 patients (30%) in 2020 (OR 1.513; 95% CI 0.96-2.37; p = 0.199). There were no significant differences in mortality during postfracture hospitalization (11.1% in 2019; 11.82% in 2020) and in the first postoperative month (16.6% in 2019; 22.66% in 2020). Four patients died during hip fracture hospitalization over 8 patients presenting PCR+. In 30 patients SARS-CoV-2 infection was diagnosed during the six months after hip fracture in 13 patients this was the cause of death (21.3% of causes). Dementia was associated with high mortality in patients with a SARS-CoV-2 diagnosis (6 out of 13 patients died with SARS-CoV-2 infection and dementia).Conclusions: An increase in the 6 postoperative months mortality in 2020 compared with the same period in 2019 was observed. An important cause of death was SARS-CoV-2 infection.