Perioperative mortality and morbidity of hip fractures among COVID-19 infected and non-infected patients: A systematic review and meta-analysis

被引:5
|
作者
Tripathy, Sujit Kumar [1 ]
Varghese, Paulson [1 ]
Panigrahi, Sibasish [1 ]
Panda, Bijnya Birajita [2 ]
Srinivasan, Anand [3 ]
Sen, Ramesh Kumar [4 ]
机构
[1] All India Inst Med Sci, Dept Orthoped, Bhubaneswar 751019, India
[2] Srirama Chandra Bhanja Med Coll & Hosp, Dept Ophthalmol, Cuttack 753007, India
[3] All India Inst Med Sci, Dept Pharmacol, Bhubaneswar 751019, India
[4] Max Hosp, Dept Orthopaed, Mohali 160055, India
关键词
Hip fracture; Femur neck fracture; Mortality; COVID-19; Pandemic; 30-DAY MORTALITY; ORTHOPEDIC SERVICE; SURGERY; MANAGEMENT; IMPACT; CARE; COMPLICATIONS; PREDICTORS; STRATEGIES; ADMISSION;
D O I
10.1016/j.cjtee.2021.05.004
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: Hip fractures among elderly patients are surgical emergencies. During COVID-19 pandemic time, many such patients could not be operated at early time because of the limitation of the medical resources, the risk of infection and redirection of medical attention to a severe infective health problem. Methods: A search of electronic databases (PubMed, Medline, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials) with the keywords "COVID", "COVID-1900, "SARS-COV-2", "Corona", "pandemic", "hip fracture", "trochanteric fracture" and "neck femur fracture" revealed 64 studies eval-uating treatment of hip fracture in elderly patients during COVID-19 pandemic time. The 30-day mor-tality rate, inpatient mortality rate, critical care/special care need, readmission rate and complications rate in both groups were evaluated. Data were analyzed using Review Manager (RevMan) V.5.3. Results: After screening, 7 studies were identified that described the mortality and morbidity in hip fractures in both COVID-19 infected (COVID-19 +) and non-infected (COVID-19 -) patients. There were significantly increased risks of 30-day mortality (32.23% COVID-19 + death vs. 8.85% COVID-19 -death) and inpatient mortality (29.33% vs. 2.62%) among COVID-19 + patients with odds ratio (OR) of 4.84 (95% CI: 3.13 -7.47, p < 0.001) and 15.12 (95% CI: 6.12 -37.37, p < 0.001), respectively. The COVID-19 + patients needed more critical care admission (OR = 5.08, 95% CI: 1.49 -17.30, p < 0.009) and they remain admitted for a longer time in hospital (mean difference = 3.6, 95% CI: 1.74 -5.45, p < 0.001); but there was no difference in readmission rate between these 2 groups. The risks of overall complications (OR = 17.22), development of pneumonia (OR = 22.25), and acute respiratory distress syndrome/acute respiratory failure (OR = 32.96) were significantly high among COVID-19 + patients compared to COVID-19 -patients. Conclusions: There are increased risks of the 30-day mortality, inpatient mortality and critical care admission among hip fracture patients who are COVID-19 +. The chances of developing pneumonia and acute respiratory failure are more in COVID-19 + patients than in COVID-19 - patients. & COPY; 2021 Chinese Medical Association. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:162 / 173
页数:12
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