IMPACT OF THE COVID-19 PANDEMIC ON FRAGILITY HIP FRACTURE MANAGEMENT AND MORTALITY RATE

Abstract

Background: The COVID-19 pandemic has greatly affected patients without COVID, including osteoporotic hip fractures. Treatment protocols and time for surgery have been disrupted and delayed resulting in unsatisfactory outcomes. This study compared the mortality rate among patients with osteoporotic hip fractures during the COVID-19 pandemic and during the prepandemic periods. Methods: The patients’ information recorded in the Fracture Liaison Service (FLS) registry was retrospectively reviewed. We defined the prepandemic group as the admissions between May 2019 and March 2020 and the pandemic group as admissions from April 2020 to February 2021. The demographic data were collected, including serum calcium and 25(OH)D levels. Time to surgery, postoperative complications, length of stay and death were obtained and compared between the two periods. Results: We included 813 patients, with 444 and 369 patients in the prepandemic and the pandemic groups, respectively. Mean age, sex and comorbidities were comparable in both groups. The proportion of patients with insufficient and deficient vitamin D was significantly higher in the pandemic group (46.41 vs. 62.85%, p<0.01). Time to surgery and length of hospital stay was significantly longer in the pandemic period (p <0.05). The mortality was higher but did not significantly differ in the pandemic period with an adjusted hazard ratio of 1.08 (95% CI = 0.76-1.54). Conclusion: Properly managing hip fractures during the pandemic is crucial to prevent and reduce morbidity and mortality. Inadequate serum vitamin D level has been noted in the pandemic group but was not associated with mortality rate.