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1.
Isr Med Assoc J ; 23(8): 475-478, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392620

RESUMO

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic had enormous impact on many aspects of our society, including huge medical, social, and economic challenges. OBJECTIVES: To evaluate the impact of the first wave of the COVID-19 pandemic and the related movement restrictions on the incidence of hip fractures in different age groups. METHODS: This single center retrospective observational study included all patients over 60 years old admitted to our hospital with the diagnosis of hip fracture during March and April 2020. Exclusion criteria were periprosthetic or pathologic fractures and multitrauma. We collected the same data on all patients with hip fractures admitted during March and April of 2018 and 2019. RESULTS: Mean patient age increased from 81.7 to 85.0 years. Only two of 49 patients tested positive for COVID-19. The data show a decrease of 38% in fracture load, but a striking decrease of 85% and 59% among sexagenarians and septuagenarian, respectively. There was no decrease among nonagenarians. Early mortality, both at 30 days and 90 days, was twice as common during the pandemic. However, stratification by age group demonstrated that the risks of early mortality were the same as previous years. Mean waiting time for surgery decreased from 27.5 to 18.9 hours. Patient discharge to home over a rehabilitation facility increased from 9% to 17. CONCLUSIONS: The COVID-19 pandemic affected the epidemiology of hip fractures in the elderly. The incidence of fractures and age distribution were significantly different from other years. Discharge destinations were also affected. The management of hip fracture patients was not compromised.


Assuntos
COVID-19 , Fraturas do Quadril , Administração dos Cuidados ao Paciente , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Fraturas do Quadril/mortalidade , Fraturas do Quadril/reabilitação , Fraturas do Quadril/terapia , Humanos , Incidência , Controle de Infecções/métodos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Avaliação de Processos e Resultados em Cuidados de Saúde , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/tendências , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação
2.
Injury ; 2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34253355
3.
Global Spine J ; : 2192568220982282, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33433244

RESUMO

STUDY DESIGN: Retrospective cohort. OBJECTIVES: We aimed to compare a large cohort of patients with vertebral compression fractures (VCF) treated in 2 centers using different protocols (conservative vs BKP) and compare mortality rates on a long-term follow-up. METHODS: Retrospective cohort held in 2 medical centers (W and AH). All patients admitted with VCF from November 2008 to January 2015 were enrolled in the study. Exclusion criteria were patients admitted with non-osteoporotic pathological fractures (such as metastatic or MM). RESULTS: Our study included 208 patients treated for VCF, 127 were treated with BKP (88 females, 69.3%) and 81 were treated conservatively (59 females, 72.8%). Patients from Centre W were older and frailer compared to the patients from AH center (Average age 75.12 ± 11.16 vs 69.13 ± 9.61 years and Frailty score of 0.16 ± 0.1 vs 0.12 ± 0.1 respectively, T-test, p < 0.01 for both). Hazard ratios (HR) for age, female gender and frailty were significant for increased mortality, frailty had the highest HR of 182.42 (CI 29.05-1145.33, p < 0.01). Multivariate Cox model was fitted and after accounting for Gender, Age and Frailty, no significant difference was found between the 2 medical centers mortality rates (p = 0.59), thus no difference in mortality rates between BKP and conservative treatment in our study. CONCLUSION: long-term follow-up following BKP treatment for VCF did not show a reduced mortality rate compared to conservative treatment after accounting for frailty, age and gender. Frailty was the most important factor in predicting mortality. Further RCTs are needed to compare the quality of life differences between the 2 treatment strategies.

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