Hip fracture patients vulnerable to Covid-19

Patients with a broken hip were up to three times more likely to die within 30 days if they had Covid-19 compared with hip patients without Covid-19, an audit of hospitals shows.

More than half of Covid-19 cases in the study were thought to have been picked up the disease in hospital, findings from the first coronavirus wave suggest.

Doctors say that hospital set-ups have improved since then as more is understood about the disease, and the oldest and most at risk patients are now likely to have been vaccinated.

Researchers hope the findings may still help clinicians plan for protecting at-risk patients admitted for orthopaedic surgery as the pandemic continues.

Nationwide study

The study looked at data from patients over 50-years-old with hip fractures who were admitted across all Scottish hospitals during the first wave of the pandemic, from March to April 2020.

First lockdown

The timeframe captures the first recorded Covid-19 case in Scotland, the start of social distancing measures, the UK lockdown, and the peak of Covid-19 cases in Scotland.

The audit included more than 830 patients. The average age was 80-years and two-thirds were women.

Hospital stay

More than half of the coronavirus infections in the study are thought to have occurred in hospital. Patients who stayed longer in hospital were more likely to acquire Covid-19, highlighting the importance of early appropriate discharge.

Improved situation

The study team caution that much has been learned since the first wave of the coronavirus pandemic. They urge that people who need to seek medical attention for injuries, including hip fracture, continue to attend hospital as normal.

The study – published in the Bone & Joint Journal – was carried out by the University of Edinburgh in collaboration with the IMPACT-Scot Study Group and the Scottish Orthopaedic Research Trust Into Trauma (SORT-IT).

The first wave of the Covid-19 pandemic was a steep learning curve for all healthcare providers, and the IMPACT Group results highlight the vulnerability of hip fracture patients to acquiring Covid-19 and the associated morbid consequences. Many of the at-risk patients will have now received the Covid-19 vaccine, and improved precautions to reduce the spread of infection have been introduced since this study took place. We hope that the study improves the understanding of Covid-19 and emphasises the need to protect these vulnerable patients by prioritising hip fracture services.

Related Links

IMPACT-Scot 2 report on COVID-19 in hip fracture patients

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