Location
Philadelphia, PA
Start Date
11-5-2022 1:00 PM
End Date
11-5-2022 4:00 PM
Description
Introduction: The effects of delayed surgical repair for traumatic hip fractures have been widely discussed in the literature, and there exists a strong association between surgical timing and patient outcomes. The COVID-19 pandemic placed a significant burden on health care systems throughout the world, with hospitals reallocating both human and physical resources to care for the critically ill. The purpose of this study is to investigate if the strain placed on hospital systems by COVID-19 and the changes to hospital operational models negatively impacted time to surgery, as well as morbidity and mortality rates of hip fractures.
Methods: A retrospective chart review was performed on 416 patients 18 years or older who were treated for traumatic hip fractures between January 2019 and November 2020 at a single academic Level 1 trauma center. Pre-operative and post-operative data were collected for each patient. The incidence of mortality and complications were captured. Statistical analysis performed were Independent T Test, Mann Whitney U Test, Chi Squared Test, Linear and Logistic Regressions to compare outcomes of patients.
Results: Two-hundred sixty-three patients were treated pre-pandemic (control; January 2019-February 2020) and 153 were treated during the pandemic (experimental; March 2020-November 2020). There were no significant differences in median time to surgery between control and experimental (22 versus 23 hours) groups, as well as no difference in readmission rates (23.2% versus 17.0%; p=0.134), overall reoperation rates (6.1% versus 2.0%; p=0.052), and 30- (7.2% versus 3.3%, p=0.095) and 90-day (1.9% versus 3.9%; p=0.22) mortality rates.
Conclusion: The established pre-pandemic practices for the throughput of hip fractures mitigated any negative impacts to surgical timing or complications during the pandemic. Time to surgery for traumatic hip fractures remains a challenge and often requires multidisciplinary care. As COVID-19 continues to impact workflow within hospitals, clinicians should strive to balance system-wide changes while ensuring timely intervention for hip fractures to optimize outcomes.
Embargo Period
6-1-2022
Included in
Timing and Outcomes of Hip Fracture Surgery During the COVID-19 Pandemic
Philadelphia, PA
Introduction: The effects of delayed surgical repair for traumatic hip fractures have been widely discussed in the literature, and there exists a strong association between surgical timing and patient outcomes. The COVID-19 pandemic placed a significant burden on health care systems throughout the world, with hospitals reallocating both human and physical resources to care for the critically ill. The purpose of this study is to investigate if the strain placed on hospital systems by COVID-19 and the changes to hospital operational models negatively impacted time to surgery, as well as morbidity and mortality rates of hip fractures.
Methods: A retrospective chart review was performed on 416 patients 18 years or older who were treated for traumatic hip fractures between January 2019 and November 2020 at a single academic Level 1 trauma center. Pre-operative and post-operative data were collected for each patient. The incidence of mortality and complications were captured. Statistical analysis performed were Independent T Test, Mann Whitney U Test, Chi Squared Test, Linear and Logistic Regressions to compare outcomes of patients.
Results: Two-hundred sixty-three patients were treated pre-pandemic (control; January 2019-February 2020) and 153 were treated during the pandemic (experimental; March 2020-November 2020). There were no significant differences in median time to surgery between control and experimental (22 versus 23 hours) groups, as well as no difference in readmission rates (23.2% versus 17.0%; p=0.134), overall reoperation rates (6.1% versus 2.0%; p=0.052), and 30- (7.2% versus 3.3%, p=0.095) and 90-day (1.9% versus 3.9%; p=0.22) mortality rates.
Conclusion: The established pre-pandemic practices for the throughput of hip fractures mitigated any negative impacts to surgical timing or complications during the pandemic. Time to surgery for traumatic hip fractures remains a challenge and often requires multidisciplinary care. As COVID-19 continues to impact workflow within hospitals, clinicians should strive to balance system-wide changes while ensuring timely intervention for hip fractures to optimize outcomes.
Comments
Presented by Kelsey Martin.