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Isr Med Assoc J ; 23(8): 469-474, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34392619

ABSTRACT

BACKGROUND: Hip fractures in elderly patients are a major cause of morbidity and mortality. Variability in length of hospital stay (LOS) was evident in this population. The coronavirus disease-2019 (COVID-19) pandemic led to prompt discharge of effected patients in order to reduce contagion risk. LOS and discharge destination in COVID-19 negative patients has not been studied. OBJECTIVES: To evaluate the LOS and discharge destination during the COVID-19 outbreak and compare it with a similar cohort in preceding years. METHODS: A retrospective study was conducted comparing a total of 182 consecutive fragility hip fracture patients operated on during the first COVID-19 outbreak to patients operated on in 2 preceding years. Data regarding demographic, co-morbidities, surgical management, hospitalization, as well as surgical and medical complications were retrieved from electronic charts. RESULTS: During the pandemic 67 fragility hip fracture patients were admitted (COVID group); 55 and 60 patients were admitted during the same time periods in 2017 and 2018, respectively (control groups). All groups were of similar age and gender. Patients in the COVID group had significantly shorter LOS (7.2 ± 3.3 vs. 8.9 ± 4.9 days, P = 0.008) and waiting time for a rehabilitation facility (7.2 ± 3.1 vs. 9.3 ± 4.9 days, P = 0.003), but greater prevalence of delirium (17.9% vs. 7% of patients, P = 0.028). In hospital mortality did not differ among groups. CONCLUSIONS: LOS and time to rehabilitation were significantly shorter in the COVID group. Delirium was more common in this group, possibly due to negative effects of social distancing.


Subject(s)
COVID-19 , Delirium , Fracture Fixation , Hip Fractures , Infection Control , Length of Stay/statistics & numerical data , Postoperative Complications , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Delirium/diagnosis , Delirium/epidemiology , Delirium/etiology , Female , Fracture Fixation/adverse effects , Fracture Fixation/methods , Fracture Fixation/rehabilitation , Hip Fractures/epidemiology , Hip Fractures/surgery , Humans , Infection Control/methods , Infection Control/organization & administration , Israel/epidemiology , Male , Organizational Innovation , Outcome and Process Assessment, Health Care , Patient Discharge/trends , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Retrospective Studies , Risk Management/organization & administration , SARS-CoV-2/isolation & purification
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