Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology
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ORIGINAL PAPER
Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology Pablo A. Slullitel 1 & Carlos M. Lucero 1 & Maria L. Soruco 2 & Jorge D. Barla 2 & Javier A. Benchimol 3 & Bruno R. Boietti 3,4 & Gerardo Zanotti 1 & Fernando Comba 1 & Danilo R. Taype-Zamboni 2 & Guido S. Carabelli 2 & Francisco Piccaluga 1 & Carlos F. Sancineto 2 & Maria Diehl 5 & Martin A. Buttaro 1 & for the HipFEIR [Hip Fracture in the Elderly – Institutional Register] Study Group Received: 28 July 2020 / Accepted: 30 July 2020 # SICOT aisbl 2020
Abstract Purpose To analyse the impact of prolonged mandatory lockdown due to COVID-19 on hip fracture epidemiology. Methods Retrospective case-control study of 160 hip fractures operated upon between December 2019 and May 2020. Based on the date of declaration of national lockdown, the cohort was separated into two groups: ‘pre-COVID time’ (PCT), including 86 patients, and ‘COVID time’ (CT), consisting of 74 patients. All CT patients tested negative for SARS-CoV-2. Patients were stratified based on demographic characteristics. Outcome measures were 30-day complications, readmissions and mortality. A logistic regression model was run to evaluate factors associated with mortality. Results Age, female/male ratio, body mass index and American Society of Anaesthesia score were similar between both groups (p > 0.05). CT patients had a higher percentage of Charlson ≥ 5 and Rockwood Frailty Index ≥ 5 scores (p < 0.05) as well as lower UCLA and Instrumental Activities of Daily Living scores (p < 0.05). This translated into a higher hemiarthroplasty/total hip arthroplasty ratio during CT (p = 0.04). Thromboembolic disease was higher during CT (p = 0.02). Readmissions (all negative for SARS-CoV-2) were similar between both groups (p = 0.34). Eight (10.8%) casualties were detected in the CT group, whereas no deaths were seen in the control group. Logistic regression showed that frailer (p = 0.006, OR 10.46, 95%CI 8.95–16.1), less active (p = 0.018, OR 2.45, 95%CI 1.45–2.72) and those with a thromboembolic event (p = 0.005, OR 30, 95%CI 11–42) had a higher risk of mortality. This work was performed at the Italian Hospital of Buenos Aires, Argentina. All authors have participated in the research. The article has not been submitted elsewhere. It is a new manuscript submission. Level of Evidence: Prognostic level 3, case-controlled study. * Pablo A. Slullitel [email protected] Carlos M. Lucero [email protected] Maria L. Soruco [email protected] Jorge D. Barla [email protected] Javier A. Benchimol [email protected] Bruno R. Boietti [email protected] Gerardo Zanotti [email protected]
Fernando Comba [email protected] Danilo R. Taype-Zamboni [email protected] Guido S. Carabelli [email protected] Francisco Piccaluga [email protected] Carlos F. Sancineto [email protected] Maria Diehl [email protected] Martin A. Buttaro [email protected] Extended author info
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