Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients' clinical presentation and comorbidity : a multicentric study in Northern Italy
© 2021. SICOT aisbl..
PURPOSE: This study aims to evaluate 30-60-90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients' clinical presentation and comorbidities.
METHODS: Between February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgically treated PFF were included. Patients' demographic characteristics, oxygen (O2) therapy, comorbidities, and AO type fracture were collected. Chi-square test or Fisher test and hazard ratio were used to assessing the correlation between mortality rate, patient characteristics, and COVID-19 status. Kaplan-Meyer curve was used to analyze 30-60-90-day mortality. Level of significance was set as p < 0.05.
RESULTS: Fifty-six patients (mean age of 82.7 ± 8.85 years) were included. Thirty-day mortality rate was 5%, which increased to 21% at 60 days and 90 days. Eleven patients died, eight due to AO type A-like and three due to AO type B-like fractures. No significant difference in mortality rate between patients with cardiopulmonary comorbidity or no cardiopulmonary comorbidity was found (p = 0.67); a significant difference in patients with chronic obstructive pulmonary disease (COPD) or history of pulmonary embolism (PE) and patients without COPD was found (p = 0.0021). A significant difference between asymptomatic/mild symptomatic COVID-19 status and symptomatic COVID-19 status was found (p = 0.0415); a significant difference was found for O2 therapy with < 4 L/min and O2 therapy ≥ 4 L/min (p = 0.0049).
CONCLUSION: Thirty-day mortality rate of COVID-19 infection and PFFs does not differ from mortality rate of non-COVID-19 PFFs. However, patients with pre-existing comorbidities and symptomatic COVID-19 infection requiring a high volume of O2 therapy have a higher incidence of 60-90-day mortality when surgically treated.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
International orthopaedics - 45(2021), 10 vom: 13. Okt., Seite 2499-2505 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fusini, Federico [VerfasserIn] |
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| Links: |
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| Themen: |
Coronavirus disease |
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| Anmerkungen: |
Date Completed 19.10.2021 Date Revised 19.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00264-021-05166-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM329455559 |
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| 100 | 1 | |a Fusini, Federico |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients' clinical presentation and comorbidity |b a multicentric study in Northern Italy |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 19.10.2021 | ||
| 500 | |a Date Revised 19.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. SICOT aisbl. | ||
| 520 | |a PURPOSE: This study aims to evaluate 30-60-90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients' clinical presentation and comorbidities | ||
| 520 | |a METHODS: Between February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgically treated PFF were included. Patients' demographic characteristics, oxygen (O2) therapy, comorbidities, and AO type fracture were collected. Chi-square test or Fisher test and hazard ratio were used to assessing the correlation between mortality rate, patient characteristics, and COVID-19 status. Kaplan-Meyer curve was used to analyze 30-60-90-day mortality. Level of significance was set as p < 0.05 | ||
| 520 | |a RESULTS: Fifty-six patients (mean age of 82.7 ± 8.85 years) were included. Thirty-day mortality rate was 5%, which increased to 21% at 60 days and 90 days. Eleven patients died, eight due to AO type A-like and three due to AO type B-like fractures. No significant difference in mortality rate between patients with cardiopulmonary comorbidity or no cardiopulmonary comorbidity was found (p = 0.67); a significant difference in patients with chronic obstructive pulmonary disease (COPD) or history of pulmonary embolism (PE) and patients without COPD was found (p = 0.0021). A significant difference between asymptomatic/mild symptomatic COVID-19 status and symptomatic COVID-19 status was found (p = 0.0415); a significant difference was found for O2 therapy with < 4 L/min and O2 therapy ≥ 4 L/min (p = 0.0049) | ||
| 520 | |a CONCLUSION: Thirty-day mortality rate of COVID-19 infection and PFFs does not differ from mortality rate of non-COVID-19 PFFs. However, patients with pre-existing comorbidities and symptomatic COVID-19 infection requiring a high volume of O2 therapy have a higher incidence of 60-90-day mortality when surgically treated | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Coronavirus disease | |
| 650 | 4 | |a Fracture | |
| 650 | 4 | |a Hip | |
| 650 | 4 | |a Intramedullary nailing | |
| 650 | 4 | |a Joint replacement | |
| 650 | 4 | |a Proximal femur | |
| 700 | 1 | |a Massè, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Risitano, Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrera, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Enrietti, Emilio |e verfasserin |4 aut | |
| 700 | 1 | |a Zoccola, Kristijan |e verfasserin |4 aut | |
| 700 | 1 | |a Bianco, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Zanchini, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Colò, Gabriele |e verfasserin |4 aut | |
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