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. 2021 May 13;18(10):5205.
doi: 10.3390/ijerph18105205.

Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case-Control Study from a Single Center in Italy

Alberto Grassi  1 , Luca Andriolo  1 , Davide Golinelli  2 , Dario Tedesco  3 , Simona Rosa  2 , Pasquale Gramegna  4 , Jacopo Ciaffi  4 , Riccardo Meliconi  4 , Maria Paola Landini  3 , Giuseppe Filardo  5 , Maria Pia Fantini  2 , Stefano Zaffagnini  1
Affiliations

Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case-Control Study from a Single Center in Italy

Alberto Grassi et al. Int J Environ Res Public Health. .

Abstract

The mortality of hip fracture (HF) patients is increased by concomitant COVID-19; however, evidence is limited to only short follow-up. A retrospective matched case-control study was designed with the aim to report the 90-day mortality and determine the hazard ratio (HR) of concomitant HF and COVID-19 infection. Cases were patients hospitalized for HF and diagnosed with COVID-19. Controls were patients hospitalized for HF not meeting the criteria for COVID-19 diagnosis and were individually matched with each case through a case-control (1:3) matching algorithm. A total of 89 HF patients were treated during the study period, and 14 of them were diagnosed as COVID-19 positive (overall 15.7%). Patients' demographic, clinical, and surgical characteristics were similar between case and control groups. At 90 days after surgery, 5 deaths were registered among the 14 COVID-19 cases (35.7%) and 4 among the 42 HF controls (9.5%). COVID-19-positive cases had a higher risk of mortality at 30 days (HR = 4.51; p = 0.0490) and 90 days (HR = 4.50; p = 0.025) with respect to controls. Patients with concomitant HF and COVID-19 exhibit high perioperative mortality, which reaches a plateau of nearly 30-35% after 30 to 45 days and is stable up to 90 days. The mortality risk is more than four-fold higher in patients with COVID-19.

Keywords: COVID-19; coronavirus; elderly; hip fracture.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Ninety-day survival of COVID-19 patients calculated for time from surgery, time from hospital admission, and time from COVID-19 diagnosis.
Figure 2
Figure 2
Ninety-day survival curve of cases and controls.
See this image and copyright information in PMC

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