Delayed hospital admission for traumatic hip fractures during the COVID-19 pandemic

Journal of Orthopaedic Surgery and Research

Stephanie Jarvis¹  David Bar-Or¹  Kristin Salottolo¹  Jennifer Pekarek²  Therese Duane³  Alexander Wessel⁴  Zachary Roberts⁵  Mark Lieser⁵  Robert Madayag⁶  Nnamdi Nwafo⁷  Chad Corrigan⁸ 

[1] ION Research, 501 East Hampden Avenue, 80113, Englewood, Colorado, USA;ION Research, 501 East Hampden Avenue, 80113, Englewood, Colorado, USA;St. Anthony Hospital, Lakewood, CO, USA;Medical City Plano, Plano, TX, USA;Penrose Hospital, Colorado Springs, CO, USA;Research Medical Center, Kansas City, MO, USA;St. Anthony Hospital, Lakewood, CO, USA;Swedish Medical Center, Englewood, CO, USA;Wesley Medical Center, Wichita, KS, USA;

关键词: Hip fracture;    Time to arrival;    COVID-19;   

DOI  :  10.1186/s13018-021-02382-w

来源: Springer

【 摘 要 】

BackgroundConcerns of contracting the highly contagious disease COVID-19 have led to a reluctance in seeking medical attention, which may contribute to delayed hospital arrival among traumatic patients. The study objective was to describe differences in time from injury to arrival for patients with traumatic hip fractures admitted during the pandemic to pre-pandemic patients.Materials and methodsThis retrospective cohort study at six level I trauma centers included patients with traumatic hip fractures. Patients with a non-fall mechanism and those who were transferred in were excluded. Patients admitted 16 March 2019–30 June 2019 were in the “pre-pandemic” group, patients were admitted 16 March 2020–30 June 2020 were in the “pandemic” group. The primary outcome was time from injury to arrival. Secondary outcomes were time from arrival to surgical intervention, hospital length of stay (HLOS), and mortality.ResultsThere were 703 patients, 352 (50.1%) pre-pandemic and 351 (49.9%) during the pandemic. Overall, 66.5% were female and the median age was 82 years old. Patients were similar in age, race, gender, and injury severity score. The median time from injury to hospital arrival was statistically shorter for pre-pandemic patients when compared to pandemic patients, 79.5 (56, 194.5) min vs. 91 (59, 420), p = 0.04. The time from arrival to surgical intervention (p = 0.64) was statistically similar between groups. For both groups, the median HLOS was 5 days, p = 0.45. In-hospital mortality was significantly higher during the pandemic, 1.1% vs 3.4%, p = 0.04.ConclusionsWhile time from injury to hospital arrival was statistically longer during the pandemic, the difference may not be clinically important. Time from arrival to surgical intervention remained similar, despite changes made to prevent COVID-19 transmission.

【 授权许可】

CC BY