Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case-Control Study from a Single Center in Italy

Alberto Grassi, Luca Andriolo, Davide Golinelli, Dario Tedesco, Simona Rosa, Pasquale Gramegna, Jacopo Ciaffi, Riccardo Meliconi, Maria Paola Landini, Giuseppe Filardo, Maria Pia Fantini, Stefano Zaffagnini

Research output: Contribution to journalArticlepeer-review

Abstract

The mortality of hip fracture (HF) patients is increased by concomitant COVID-19; however, evidence is limited to only short follow-up. A retrospective matched case-control study was designed with the aim to report the 90-day mortality and determine the hazard ratio (HR) of concomitant HF and COVID-19 infection. Cases were patients hospitalized for HF and diagnosed with COVID-19. Controls were patients hospitalized for HF not meeting the criteria for COVID-19 diagnosis and were individually matched with each case through a case-control (1:3) matching algorithm. A total of 89 HF patients were treated during the study period, and 14 of them were diagnosed as COVID-19 positive (overall 15.7%). Patients' demographic, clinical, and surgical characteristics were similar between case and control groups. At 90 days after surgery, 5 deaths were registered among the 14 COVID-19 cases (35.7%) and 4 among the 42 HF controls (9.5%). COVID-19-positive cases had a higher risk of mortality at 30 days (HR = 4.51; p = 0.0490) and 90 days (HR = 4.50; p = 0.025) with respect to controls. Patients with concomitant HF and COVID-19 exhibit high perioperative mortality, which reaches a plateau of nearly 30-35% after 30 to 45 days and is stable up to 90 days. The mortality risk is more than four-fold higher in patients with COVID-19.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalInt J Environ Res Public Health
Volume18
Issue number10
DOIs
Publication statusPublished - May 13 2021

Keywords

  • COVID-19
  • COVID-19 Testing
  • Case-Control Studies
  • Hip Fractures/surgery
  • Humans
  • Italy/epidemiology
  • Retrospective Studies
  • SARS-CoV-2

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