COVID-19 and Proximal Femur Fracture in Older Adults-A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU).
J Am Med Dir Assoc
; 23(4): 576-580, 2022 04.
Article
em En
| MEDLINE
| ID: mdl-34678268
ABSTRACT
OBJECTIVES:
COVID-19 can be a life-threatening illness, especially for older patients. The COVID-19 outbreak created a dramatic organizational challenge in treating infected patients requiring surgical treatment, like those suffering a proximal femur fracture, in a pandemic setting. We investigate the impact of a COVID-19 infection in patients with a proximal femur fracture not only on mortality but also on quality of life (QoL), length of stay, and discharge target.DESIGN:
Retrospective cohort analysis from July 1, 2020, to December 31, 2020. The Registry for Geriatric Trauma collected the data prospectively. Patient groups with and without COVID-19 infection were compared using linear and logistic regression models. SETTING ANDPARTICIPANTS:
Retrospective multicenter registry study including patients aged ≥70 years with proximal femur fracture requiring surgery from 107 certified Centers for Geriatric Trauma in Germany, Austria, and Switzerland.MEASURES:
The occurrence and impact of COVID-19 infection in patients suffering a proximal femur fracture were measured regarding in-house mortality, length of stay, and discharge location. Moreover, QoL was measured by the validated EQ-5D-3L questionnaire.RESULTS:
A total of 3733 patients were included in our study. Of them, 123 patients tested COVID-19 positive at admission. A COVID-19 infection resulted in a 5.95-fold higher mortality risk (odds ratio 5.95, P < .001], a length of stay prolonged by 4.21 days [regression coefficient (ß) 4.21, P < .001], a reduced QoL (ß -0.13, P = .001), and a change in discharge target, more likely to their home instead of another inpatient facility like a rehabilitation clinic (P = .013). CONCLUSIONS AND IMPLICATIONS The impact of a COVID-19 infection in patients suffering a proximal femur fracture is tremendous. The infected patients presented a dramatic rise in mortality rate, were significantly less likely to be discharged to a rehabilitation facility, had a longer in-hospital stay, and a reduced QoL.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fraturas do Fêmur
/
COVID-19
/
Fraturas do Quadril
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Aged
/
Humans
Idioma:
En
Revista:
J Am Med Dir Assoc
Assunto da revista:
HISTORIA DA MEDICINA
/
MEDICINA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Alemanha