scholarly journals PERIOPERATIVE MANAGEMENT AND OUTCOME OF HIP FRACTURES DURING THE COVID-19 PANDEMIC

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
A Camblor Valladares ◽  
L Lanuza Lagunilla ◽  
P J Suárez-Anta Rodríguez ◽  
A Meneses Gutiérrez ◽  
A García Arias ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Waiting Time ◽  
Hip Fractures ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Tertiary Hospital ◽  
Mean Waiting Time ◽  
The Mean ◽  
Complications Rate ◽  
Relevant Variation

Abstract INTRODUCTION The pandemic caused by the SARS-Cov-2 coronavirus has generated unprecedented pressure on healthcare systems. Higher mortality rates have been reported in elderly patients. Those with a hip fracture are especially vulnerable. MATERIAL AND METHODS Retrospective study in which we analyzed the management and associated perioperative complications rate in patients aged over 65 years who attended a tertiary hospital in Spain with hip fracture during the COVID-19 first alarm status decree . We compared the results with a cohort of similar patients treated during the same period in 2019. RESULTS A total of 102 hip fractures were recorded in 2019, with a mean age of 85 years. 87.5% were treated surgically in our hospital, with mean waiting time of 4.6 days and mean stay of 11.3 days. In 2020, 107 hip fractures were recorded, with a mean age of 86 years. A total of 74.6% underwent surgery in our center, with a mean waiting time of 2.8 days and a mean hospital stay of 10.9 days. The rate of major complications and exitus was 8.9% and 6.7% respectively in 2019, and 9.4% and 7.8% in 2020. CONCLUSIONS The number of hip fractures increased despite the declaration of the state of alarm in comparison with the decrease in the rest of the trauma emergencies. During this period the mean waiting time for surgery was shorter. There was no relevant variation in the demographic characteristics of the patients, nor in the rate of complications and reported exitus.

scholarly journals The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽  
2021 ◽  
pp. 146040862094972
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory ◽  
Gavin Gordon ◽  
Fiona Smith ◽  
Andrew Jennings
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Hospital Admissions ◽  
The Elderly ◽  
Primary Outcome Measure ◽  
Time To Death ◽  
Significant Difference ◽  
The Mean ◽  
The Impact ◽  
Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

scholarly journals Design and biomechanical study of slide-poking external fixator for hip fracture

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052095093
Author(s):  
Hua-Biao Chen ◽  
Hong-Bo Wu ◽  
Min Chen ◽  
Yu-Liang Huang
Keyword(s):  
Hip Fracture ◽  
Femoral Head ◽  
Hip Fractures ◽  
External Fixator ◽  
Dynamic Hip Screw ◽  
Control Groups ◽  
Vertical Loading ◽  
Hip Screw ◽  
The Mean ◽  
And Control

Background Femoral head collapse and coxa vara lead to internal fixator failure in elderly patients with hip fracture. External fixator application is an optimal choice; however, the existing methods have many disadvantages. Methods Type 31-A1.3 hip fracture models were developed in nine pairs of 1-year-old fresh bovine corpse femur specimens. Each left femur specimen was fixed by a dynamic hip screw (control group), and each right femur specimen was fixed by the slide-poking external fixator (experimental group). Vertical loading and torsion tests were then performed in both groups. Results In the vertical loading experiment, a 1000-N load was implemented. The mean vertical downward displacement of the femoral head in the experimental and control groups was 1.49322 ± 0.116280 and 2.13656 ± 0.166374 mm, respectively. In the torsion experiment, when the torsion was increased to 10.0 Nm, the mean torsion angle in the experimental and control groups was 7.9733° ± 1.65704° and 15.4889° ± 0.73228°, respectively. The slide-poking external fixator was significantly more resistant to compression and rotation than the dynamic hip screw. Conclusion The slide-poking external fixator for hip fractures that was designed and developed in this study can provide sufficient stability to resist compression and rotation in hip fractures.

scholarly journals Assessment of patients waiting and service times in the ophthalmology clinic of a public tertiary hospital in Nigeria

2020 ◽  
Vol 54 (4) ◽  
pp. 231-237
Author(s):  
Lateefat B. Olokoba ◽  
Kabir A. Durowade ◽  
Feyi G. Adepoju ◽  
Abdulfatai B. Olokoba
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Sampling Technique ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Ethical Review ◽  
Cross Sectional ◽  
Arrival Times ◽  
The Mean ◽  
Service Times

Introduction: Long waiting time in the out-patient clinic is a major cause of dissatisfaction in Eye care services. This study aimed to assess patients’ waiting and service times in the out-patient Ophthalmology clinic of UITH. Methods: This was a descriptive cross-sectional study conducted in March and April 2019. A multi-staged sampling technique was used. A timing chart was used to record the time in and out of each service station. An experience based exit survey form was used to assess patients’ experience at the clinic. The frequency and mean of variables were generated. Student t-test and Pearson’s correlation were used to establish the association and relationship between the total clinic, service, waiting, and clinic arrival times. Ethical approval was granted by the Ethical Review Board of the UITH. Result: Two hundred and twenty-six patients were sampled. The mean total waiting time was 180.3± 84.3 minutes, while the mean total service time was 63.3±52.0 minutes. Patient’s average total clinic time was 243.7±93.6 minutes. Patients’ total clinic time was determined by the patients’ clinic status and clinic arrival time. Majority of the patients (46.5%) described the time spent in the clinic as long but more than half (53.0%) expressed satisfaction at the total time spent at the clinic. Conclusion: Patients’ clinic and waiting times were long, however, patients expressed satisfaction with the clinic times.

scholarly journals Medical and economic consequences of perioperative complications in older hip fracture patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Tom Knauf ◽  
Juliana Hack ◽  
Juliane Barthel ◽  
Daphne Eschbach ◽  
Carsten Schoeneberg ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Acute Care ◽  
Hip Fractures ◽  
Perioperative Complications ◽  
Economic Consequences ◽  
Type Ii ◽  
Type Iii ◽  
Treatment Type ◽  
Barthel Score ◽  
Care Costs

Abstract Summary Patients suffering from complications during inpatient treatment after hip fracture surgery are associated with a worse mid-term outcome. While surgically treatable complications only delay the healing process, internal complications seem to worsen the outcome in the long run. All complications come with significant increased costs during the hospital stay. Purpose Due to the demographic changes, the importance of hip fractures is still increasing nowadays. Not only surgical but also medical complications represent a major challenge in the treatment of those patients. Nevertheless, only few is known about the functional, medical, and economic consequences of complications. Methods A total of 402 hip fracture patients ≥ 60 years were observed prospectively at a German university hospital. Complications were assessed during the inpatient stay and classified by Clavien and Dindo. Afterwards their influence on acute care costs was examined as well as their influence on the mortality, health-related quality of life (HRQL) (EQ5D), functional capacities (Barthel index), and mobility (Tinetti score) in the follow-up periods of 6 and 12 months. Results Complications that required surgical revision/treatment (type III) were associated with an increased 6 months’ mortality, while type II and IV complications did not influence mortality after 6 and 12 months. Six months after surgery, HRQL, Barthel score, and Tinetti score were reduced in patients suffering from all different types of complications. After 12 months however, HRQL, Barthel score, and Tinetti score following type II and IV complications remained reduced, while the scores improved in patients suffering from type III complication. All types of complications led to significantly increased acute care costs. Conclusions The results of the present study emphasize the crucial role of perioperative complications in older patients with hip fractures. Therefore, special attention has to be given to the prevention of those complications, e.g., with orthogeriatric treatment models, which have been shown to be effective in the reduction of complications.

scholarly journals Estimation of the mean waiting time of a customer subject to balking: a simulation study

2007 ◽  
Vol 19 (1) ◽  
pp. 63-63
Author(s):  
Jaejin Jang ◽  
Jaewoo Chung ◽  
Jungdae Suh ◽  
Jongtae Rhee
Keyword(s):  
Waiting Time ◽  
Simulation Study ◽  
Mean Waiting Time ◽  
The Mean

scholarly journals Waiting Time Problems for Patterns in a Sequence of Multi-State Trials

Mathematics ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 1893
Author(s):  
Bara Kim ◽  
Jeongsim Kim ◽  
Jerim Kim
Keyword(s):  
Waiting Time ◽  
Time Distribution ◽  
Probability Generating Function ◽  
Finite Collection ◽  
Numerical Inversion ◽  
Analytic Method ◽  
Waiting Time Distribution ◽  
Mean Waiting Time ◽  
The Matrix ◽  
The Mean

In this paper, we investigate waiting time problems for a finite collection of patterns in a sequence of independent multi-state trials. By constructing a finite GI/M/1-type Markov chain with a disaster and then using the matrix analytic method, we can obtain the probability generating function of the waiting time. From this, we can obtain the stopping probabilities and the mean waiting time, but it also enables us to compute the waiting time distribution by a numerical inversion.

scholarly journals Processor-sharing and random-service queues with semi-Markovian arrivals

2005 ◽  
Vol 42 (02) ◽  
pp. 478-490
Author(s):  
De-An Wu ◽  
Hideaki Takagi
Keyword(s):  
Waiting Time ◽  
Sojourn Time ◽  
Time Distribution ◽  
Arrival Process ◽  
Interarrival Time ◽  
Size Distributions ◽  
Processor Sharing ◽  
Queue Size ◽  
Mean Waiting Time ◽  
The Mean

We consider single-server queues with exponentially distributed service times, in which the arrival process is governed by a semi-Markov process (SMP). Two service disciplines, processor sharing (PS) and random service (RS), are investigated. We note that the sojourn time distribution of a type-lcustomer who, upon his arrival, meetskcustomers already present in the SMP/M/1/PS queue is identical to the waiting time distribution of a type-lcustomer who, upon his arrival, meetsk+1 customers already present in the SMP/M/1/RS queue. Two sets of system equations, one for the joint transform of the sojourn time and queue size distributions in the SMP/M/1/PS queue, and the other for the joint transform of the waiting time and queue size distributions in the SMP/M/1/RS queue, are derived. Using these equations, the mean sojourn time in the SMP/M/1/PS queue and the mean waiting time in the SMP/M/1/RS queue are obtained. We also consider a special case of the SMP in which the interarrival time distribution is determined only by the type of the customer who has most recently arrived. Numerical examples are also presented.

scholarly journals The mean waiting time to a repetition

1983 ◽  
Vol 15 (01) ◽  
pp. 216-218
Author(s):  
Gunnar Blom
Keyword(s):  
Waiting Time ◽  
Mild Condition ◽  
Random Variables ◽  
Stationary Sequence ◽  
Mean Waiting Time ◽  
The Mean

Let X 1, X2, · ·· be a stationary sequence of random variables and E 1 , E 2 , · ··, EN mutually exclusive events defined on k consecutive X's such that the probabilities of the events have the sum unity. In the sequence E j1 , E j2 , · ·· generated by the X's, the mean waiting time from an event, say E j1 , to a repetition of that event is equal to N (under a mild condition of ergodicity). Applications are given.

How many random digits are required until given sequences are obtained?

1982 ◽  
Vol 19 (03) ◽  
pp. 518-531 ◽  
Author(s):  
Gunnar Blom ◽  
Daniel Thorburn
Keyword(s):  
Generating Function ◽  
Waiting Time ◽  
Probability Generating Function ◽  
Recursive Formula ◽  
Fixed Number ◽  
Digit Sequence ◽  
Mean Waiting Time ◽  
The Mean ◽  
The Given

Random digits are collected one at a time until a given k -digit sequence is obtained, or, more generally, until one of several k -digit sequences is obtained. In the former case, a recursive formula is given, which determines the distribution of the waiting time until the sequence is obtained and leads to an expression for the probability generating function. In the latter case, the mean waiting time is given until one of the given sequences is obtained, or, more generally, until a fixed number of sequences have been obtained, either different sequences or not necessarily different ones. Several results are known before, but the methods of proof seem to be new.

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