التفاصيل البيبلوغرافية
| العنوان: |
Peri-operative Outcomes and Predictors of Mortality in COVID-19 Positive Patients with Hip Fractures: A Multicentre Study in the UK. |
| المؤلفون: |
De, Chiranjit, Wignall, Alice, Giannoudis, Vasileios, Jimenez, Andrea, Sturdee, Simon, Aderinto, Joseph, Pandit, Hemant, Palan, Jeya, Gulati, Aashish |
| المصدر: |
Indian Journal of Orthopaedics; Dec2020 Supplement 2, Vol. 54, p386-396, 11p |
| مصطلحات موضوعية: |
MORTALITY risk factors, FRACTURE fixation, BONE fractures, HIP joint injuries, MEDICAL cooperation, POSTOPERATIVE period, RESEARCH, RISK assessment, SURGICAL complications, PERIOPERATIVE care, COVID-19, COVID-19 pandemic |
| مصطلحات جغرافية: |
UNITED Kingdom |
| مستخلص: |
Aim: This UK based multi-centre study reports clinical characteristics, early outcomes and predictors of mortality in 34 consecutive COVID-19-positive hip fractures so that the lessons learnt could be utilised in other parts of World who are at a different phase of the pandemic. Methods: This study analysed patient admitted with hip fractures with COVID positive swabs, between March and May'2020 in three large hospitals covering a population of nearly two million. Data was collected on demographic profile, peri-operative variables, post-operative complications and mortality. The specific aim was to identify any variables, which could predict high 30-day mortality. Results: Overall, 12% of hip fractures were COVID positive with the mortality rate of 41.2%. The higher age (p = 0.036) and male gender (p = 0.025) was significantly associated with mortality and most of the deaths were between American Society of Anaesthesiologists (ASA) grade 3 and 4 patients. The patients having intramedullary (IM) nailing were more likely to die (p = 0.02). There was no difference in laboratory parameters but there was significant difference in findings on chest radiographs (p < 0.001), post-operative oxygen requirements (p = 0.006) and early respiratory complications (p = 0.006). Conclusion: This study suggests that the mortality following surgery for a hip fracture in COVID-positive patients is strikingly high and is associated with higher age and male gender. Higher mortality has been observed for extracapsular fracture operated with intramedullary nailing. In the immediate post-operative period, rapid deterioration of chest imaging, higher oxygen requirement and early pulmonary complications can serve as warning signs and predicting factors for higher mortality. [ABSTRACT FROM AUTHOR] |
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