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Hip fracture mortality in patients co-infected with coronavirus disease 2019: a comparison of the first two waves of the United Kingdom pandemic during the pre-vaccine era

2022; Springer Science+Business Media; Volume: 46; Issue: 2 Linguagem: Inglês

10.1007/s00264-021-05269-x

1432-5195

Fatima Rashid, David H. Hawkes, Aatif Mahmood, William J. Harrison, Sophie Miller, Shoaib Khan, Mohammed As-Sultany, Mathias Thomas Nagy, Gautam Reddy, Richard Limb, Nasri Zreik, Ebrahim Mahomed, Josh Howard, Prakash Palaparthy, Aadam Shah, Calvin Mathias, Graeme Wilson, Vishvas Shetty, Abu Saeed, Rory Cuthbert, Surendra Patnaik, Carol K. K. Chan, Jehan Zaib, Yusuf Hasan, M. K. Sykes, Andrea Pujol, Donald Osarumwense, Aleksandra Adamczyk, Tom Cash, Akshdeep Bawa, Tom Havenhand, Muhammed Amer Bashir, Rebecca Critchley, Ibrahim Jaly, Muyed Mohamed, Wayne Ng Weiyun, A. Gibbon, Srikanth Mudiganty, Salman Ali, Shan Rias, Wahidun Nabi, Jason J. Ong, Sam Trowbridge, Mark Harris, S.M. Gandhi, Panagiotis Armoni, Shafali Khanom, Moritz Lebe,

Long-Term Effects of COVID-19

In the UK, deaths associated with COVID-19 have occurred in two waves. Evidence has shown an increase in 30-day mortality for hip fracture patients co-infected with COVID-19. However, there are no studies analysing mortality trends between the first two waves of the UK pandemic. Additionally, hospital versus community acquired COVID-19 infection between the two waves has not been analysed. Furthermore, predictive factors of 30-day mortality have not been fully evaluated.Data from two audits conducted by the CHIP collaborative group were used: a published regional audit in England of nine hospitals providing the COVID-19 negative cases and an unpublished UK national audit of 43 hospitals, which provided the COVID-19 positive cases. Data collection for the COVID-19 positive cases was from 23 March to 31 December 2020. September 1, 2020 was used to define the transition between the two waves.There were 517 COVID-19 positive hip fracture patients and 1445 COVID-19 negative hip fracture patients. Overall, 30-day mortality rates were 5.7% in the COVID-19 negative group and 22.4% in the COVID-19 positive patients (p < 0.001). A difference in survival function between the first and second waves was found (p = 0.038). To allow for significant demographic differences, a matched analysis of 185 patients found a 26.5% 30-day mortality in the first wave compared to 21.1% in the second wave (p = 0.222). Within the COVID-19 positive groups, the virus was hospital acquired in 66.7% of cases in the first wave and 72.8% of cases in the second wave (p = 0.130). Independent predictors of mortality were found to include COVID-19 positive status, AMTS ≤ 6, male gender and age.There was a reduction in 30-day mortality for hip fracture patients co-infected with COVID-19 between the two UK pandemic waves but this was not statistically significant. There was no reduction in hospital acquired COVID-19 infection between the two waves.