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Multicenter Study
. 2021 Feb;31(2):341-347.
doi: 10.1007/s00590-020-02778-0. Epub 2020 Sep 4.

30-day mortality for fractured neck of femur patients with concurrent COVID-19 infection

Leanne Dupley  1 , Tobenna J Oputa  2 , James T Bourne  3 ; North West COVID NOF Study Group
Collaborators, Affiliations
Multicenter Study

30-day mortality for fractured neck of femur patients with concurrent COVID-19 infection

Leanne Dupley et al. Eur J Orthop Surg Traumatol. 2021 Feb.

Abstract

Introduction: Risk factors for mortality associated with COVID-19 have been reported to include increased age, male sex and certain comorbidities. Fracture neck of femur (NOF) patients is high-risk surgical patients, often with multiple comorbidities and advanced age. We quantify the 30-day mortality rate in fractured NOF patients with a positive peri-operative COVID-19 antigen test and identify risk factors for increased mortality.

Methods: This is a retrospective multi-centre review of all patients admitted with a fractured NOF and a confirmed laboratory diagnosis of COVID-19 between 1 March and 26 April 2020. Demographic data, comorbidities, ASA grade and date of death (if applicable) were collected.

Results: There were 64 patients in the cohort with an overall 30-day mortality rate of 32.8% (n = 21). Thirty-five (55%) were female, and mean age was 83 (SD 9, range 46-100) years. There was significantly increased mortality for those with a history of myocardial infarction (p = 0.03). Sixty-four percent of patients underwent surgery within the 36-h target, which is comparable to previous data for the same time of year. Overall mortality increased to 50% (n = 32) at 45 days post-operatively.

Conclusion: This is a large review of 30-day mortality in NOF patients with concurrent COVID-19 infection. We report a substantial increase from the pre-COVID-19 mean 30-day mortality rate (6.5% in 2019). We highlight the need for counselling patients when presenting with a NOF in relation to peri-operative COVID-19 infection and the associated increased risks.

Keywords: COVID-19; Fractured neck of femur; Hip fracture; Mortality; SARS-CoV-2.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Survival analysis
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