2 research outputs found
Is it really advantageous to operate proximal femoral fractures within 48 h from diagnosis? – A multicentric retrospective study exploiting COVID pandemic-related delays in time to surgery
Objectives: Hip fractures in the elderly are common injuries that need timely surgical management. Since the beginning of the pandemic, patients with
a proximal femoral fracture (PFF) experienced a delay in time to surgery. The primary aim of this study was to evaluate a possible variation in mortality
in patients with PFF when comparing COVID-19 negative versus positive.
Methods: This is a multicentric and retrospective study including 3232 patients with PFF who underwent surgical management. The variables
taken into account were age, gender, the time elapsed between arrival at the emergency room and intervention, pre-operative American Society of
Anesthesiology score, pre-operative cardiovascular and respiratory disease, and 10-day/1-month/6-month mortality. For 2020, we had an additional
column, “COVID-19 swab positivity.”
Results: COVID-19 infection represents an independent mortality risk factor in patients with PFFs. Despite the delay in time-to-surgery occurring in
2020, no statistically significant variation in terms of mortality was detected. Within our sample, a statistically significant difference was not detected in
terms of mortality at 6 months, in patients operated within and beyond 48 h, as well as no difference between those operated within or after 12/24/72 h.
The mortality rate among subjects with PFF who tested positive for COVID-19 was statistically significantly higher than in patients with PFF who
tested. COVID-19 positivity resulted in an independent factor for mortality after PFF.
Conclusion: Despite the most recent literature recommending operating PFF patients as soon as possible, no significant difference in mortality was
found among patients operated before or after 48 h from diagnosis