Early Mortality After Hip Fracture Surgery in COVID-19 Patients: A Systematic Review and Meta-analysis

Overview

Journal J Orthop

Specialty Orthopedics

Date 2020 Nov 23

PMID 33223732

Citations 34

Authors

Kevin C Wang

Ryan Xiao

Zoe B Cheung

Joseph P Barbera

David A Forsh

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this systematic review and meta-analysis was to assess the risk of early mortality in hip fracture patients with COVID-19 infection who undergo surgical intervention.

Data Sources: MEDLINE (PubMed) and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases.

Study Selection: Studies were included in the systematic review if they reported postoperative mortality in patients with COVID-19 infection who underwent operative intervention for hip fracture. From this selection of studies, only investigations that reported postoperative mortality in a COVID-positive and a non-COVID group were included in the meta-analysis.

Data Extraction: Data regarding patient demographics, age, and sex were recorded. Additional data that was extracted included study location, data collection period, length of follow-up, COVID testing methodology, COVID testing results, and number of patients who underwent operative versus nonoperative management. The primary outcome of interest was postoperative mortality.

Data Synthesis: Random effects meta-analyses were performed to assess the pooled relative risk of postoperative mortality according to COVID status. Odds ratios and 95% confidence intervals (CI) were calculated.

Conclusions: The overall pooled mortality rate in the early postoperative period for hip fracture patients with concomitant COVID-19 infection was 32.6%. The relative risk for postoperative mortality in COVID-positive patients compared to non-COVID patients was 5.66 (95% CI 4.01-7.98; p < 0.001). The currently available literature demonstrates that COVID-19 infection represents a substantial risk factor for early postoperative mortality in the already susceptible hip fracture population. Further investigations will be needed to assess longer-term morbidity and mortality in this patient population.

Level Of Evidence: Therapeutic Level IV.

Citing Articles

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Elhadidy H, Politano G, Onorati R, Catozzi D, Gianino M PLoS One. 2024; 19(7):e0305966.

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Balziano S, Greenstein N, Apterman S, Fogel I, Baran I, Prat D Arch Osteoporos. 2023; 18(1):123.

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COVID-19 Infection Was Associated with the Functional Outcomes of Hip Fracture among Older Adults during the COVID-19 Pandemic Apex.

Tay H, Wu W, Peng C, Liu K, Yu T, Chen I Medicina (Kaunas). 2023; 59(9).

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