Incidence of hip fractures in period of covid-19 pandemic

Abstract

Abstract: 

INTRODUCTION:

Most fractures occur at home as a result of accidental falls, so it was to be expected that the policy of social isolation would not prevent them.

For this same reason, a significant reduction in the incidence of fragility fractures of the hip was not anticipated a priori during this period. However, while several authors have observed a general decrease of up to 40% in the number of care for fracture, noting at the same time the non-decrease in the incidence of fragility fractures in general or of hip fractures in particular, Others have identified a specific reduction in the incidence of this type of fracture, although recognizing that a late presentation may have occurred in the temporal evolution of the pandemic. In any case, its surgery has been, is and will be one of the most commonly performed operations during the entire time of the pandemic, reaching more than 50% of hospitalization surgeries for several clinical series.

OBJECTIVE:

The objective of this study is to demonstrate the incidence of hip fractures in times of pandemic with quarantine restrictions that are hospitalized and with corresponding treatment, comparing data with the last two years without quarantine restrictions.

MATERIALS AND METHODS:

longitudinal and comparative retrospective study in patients of both sexes, admitted to the Italian hospital in Córdoba between 45 and 96 years old, with an average age of 70 years with surgical conduct fractures in the years 2018, 2019 without pandemic restriction, comparing their data with the year 2020 affected by the COVID-19 Pandemic and its quarantine status. We used exclusion criteria for scheduled surgeries and only emergency admissions with a diagnosis of hip fracture were included. The patients were followed from admission to hospital discharge.

RESULTS:

Comparing emergency trauma consultation periods, a significant reduction in the number of emergency visits was identified in the 2020 period, which had approximately a quarter of trauma admissions of any other period studied. No statistically significant differences were found in the category of admissions for hip fracture, when we compared the different periods (p = 0.2). In the periods studied, hip fracture was the most common reason for hospital admissions. In addition, the number of hospital admissions for hip fracture remained relatively stable during these periods: 236 patients in the 2018 period, 244 in the 2019 period, 252 in the 2020 period with a slight increase in it during the period of preventive social isolation and Mandatory during the COVID-19 pandemic.

CONCLUSION:

The most important finding identified in the present study is that the absolute volume of admissions for hip fracture remained stable during the 2020 pandemic period. Despite the restrictions, no variations were recorded in epidemiological or pathological data regarding hip fractures.

When developing contingency plans to reallocate resources during states of emergency, care must be taken not to assume that all trauma presentations will diminish. Health problems such as hip fractures can, in fact, remain stable in incidence during those times or even increase. In addition, since fractures disproportionately affect an elderly population with multiple comorbidities, operative delays can increase the risks of hospital mortality and nosocomial infection with the Covid-19 virus.