Factors associated with the successful removal of indwelling urinary catheters post-operatively in the fragility hip fracture patient

Objectives: To better elucidate how the COVID-19 pandemic has affected the operatively treated geriatric hip fracture population and how the health care system adapted to pandemic dictated procedures. Design: Retrospective cohort study. Setting: A community hospital. Participants: Individuals ≥65 years of age presented with a proximal femoral fracture from a low-energy mechanism undergoing operative treatment from January 17, 2020 to July 2, 2020 (N = 125). Measurements: We defined 3 phases of healthcare system response: pre-COVID-19, acute phase, and subacute phase. Thirty-day mortality, time to operating room (OR), length of stay, time to start physical therapy, perioperative complications, delirium rate, hospice admission rate, discharge dispositions, readmission rate, and the reason of surgery delay were assessed. Results: The number of hip fractures has remained constant during the pandemic. The 30-day mortality rate, time to OR, and length of stay were higher in the pandemic compared to the pre-pandemic. Those who had a longer wait time to OR (≥ 24 hours) had more complications and increased 30-day mortality rates. Some of the surgery delays were related to OR unavailability as a consequence of the COVID-19 pandemic. Surgery was delayed in 3 patients who were on direct oral anticoagulants (DOACs) in pandemic but none for pre-pandemic period. Conclusion: This is the first study to compare the effect of the acute and subacute phases of the pandemic on uninfected hip fracture patients. In the age of COVID-19, to provide the best care for the vulnerable geriatric orthopedic populations, the healthcare system must adopt new protocols. We should still aim to promote prompt surgical care when indicated. It is important to ensure adequate resource availability, such as OR time and staff so that hip fracture patients may continue to receive rapid access to surgery. A multidisciplinary approach remains the key to the management of fragility hip fracture patients during the pandemic.

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Factors associated to institutionalization and mortality over three years, in elderly people with a hip fracture—An observational study

Maturitas ◽

10.1016/j.maturitas.2016.04.005 ◽

2016 ◽

Vol 89 ◽

pp. 9-15 ◽

Cited By ~ 29

Author(s):

Francisco Uriz-Otano ◽

Jorge Pla-Vidal ◽

Gregorio Tiberio-López ◽

Vincenzo Malafarina

Keyword(s):

Hip Fracture ◽

Observational Study ◽

Elderly People ◽

Factors Associated

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Factors associated with changes in mobility and living arrangements in a comprehensive geriatric outpatient assessment after hip fracture

Disability and Rehabilitation ◽

10.3109/09638288.2015.1074728 ◽

2015 ◽

Vol 38 (12) ◽

pp. 1125-1133 ◽

Cited By ~ 4

Author(s):

Maria Nuotio ◽

Tiina Luukkaala

Keyword(s):

Hip Fracture ◽

Living Arrangements ◽

Factors Associated

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Morbidity and mortality after fragility hip fracture in a Saudi Arabian population: Report from a single center

Journal of International Medical Research ◽

10.1177/0300060517706283 ◽

2017 ◽

Vol 45 (3) ◽

pp. 1175-1180 ◽

Cited By ~ 6

Author(s):

Mir Sadat-Ali ◽

Moaad Alfaraidy ◽

Abdulaziz AlHawas ◽

Ahmed Abdallah Al-Othman ◽

Dakheel A Al-Dakheel ◽

...

Keyword(s):

Hip Fracture ◽

Mortality Rate ◽

Demographic Data ◽

Femoral Fractures ◽

Morbidity And Mortality ◽

High Morbidity ◽

Fragility Hip Fracture ◽

Asa Score ◽

Telephone Interviews ◽

American Society

Objective To determine the functional morbidity and mortality after fragility hip fracture and compare the mortality with three other common diseases. Methods Data were collected from patients admitted to King Fahd Hospital of the University, AlKhobar from January 2010 to December 2014. Demographic data included the preoperative American Society of Anesthesiologists (ASA) score as assessed by the anesthetist and the type of surgery. Personal and telephone interviews were performed, and data were entered into a database and analyzed. Results We identified 203 patients with fragility proximal femoral fractures, and the data of 189 patients (109 male, 80 female; average age, 66.90 ± 13.43 years) were available for analysis. The overall mortality rate was 26.98% (51 patients). The mortality rate was significantly higher among patients with an ASA score of 4 (36.36%) than 1 (20.45%). With respect to morbidity, only 48.23% of patients were able to return to their pre-fracture status; 32.35% of those who required assisted walking and 83.4% of those who required a wheelchair became bedridden. Conclusions Our data demonstrate that patients with fragility hip fractures have high morbidity and a mortality rate approaching 30%. Age and the ASA score significantly influence this high mortality rate.

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