scholarly journals Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Anoop R. Galivanche ◽  
Michael R. Mercier ◽  
Christopher A. Schneble ◽  
Jordan Brand ◽  
Neil Pathak ◽  
...  
2020 ◽  
Vol 32 (10) ◽  
pp. 649-657
Author(s):  
Bo-Lin Chiou ◽  
Yu-Fu Chen ◽  
Hong-Yaw Chen ◽  
Cheng-Yen Chen ◽  
Shu-Chuan Jennifer Yeh ◽  
...  

Abstract Objective To explore the economic burdens of hip fracture surgery in patients referred to lower-level medical institutions and to evaluate how referral systems affect costs and outcomes of hip fracture surgery. Design A nationwide population-based retrospective cohort study. Setting All hospitals in Taiwan. Participants A total of 7500 patients who had received hip fracture surgery (International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic codes 820.0 ∼ 820.9 and procedure codes 79.15, 79.35, 81.52, 81.53) performed in 1997 to 2013. Main outcome measures Total costs including outpatient costs, inpatient costs and total medical costs and medical outcomes including 30-day readmission, 90-day readmission, infection, dislocation, revision and mortality. Results The patients were referred to a lower medical institution after hip fracture surgery (downward referral group) and 3034 patients continued treatment at the same medical institution (non-referral group). Demographic characteristics, clinical characteristics and institutional characteristics were significantly associated with postoperative costs and outcomes (P < 0.05). On average, the annual healthcare cost was New Taiwan Dollars (NT$)2262 per patient lower in the downward referral group compared with the non-referral group. The annual economic burdens of the downward referral group approximated NT$241 million (2019 exchange rate, NT$30.5 = US$1). Conclusions Postoperative costs and outcomes of hip fracture surgery are related not only to demographic and clinical characteristics, but also to institutional characteristics. The advantages of downward referral after hip fracture surgery can save huge medical costs and provide a useful reference for healthcare authorities when drafting policies for the referral system.


2020 ◽  
Author(s):  
Xiaowei Wang ◽  
Jianwen Zhao ◽  
Huayong Zheng ◽  
Jianzhen Zhang ◽  
Tiansheng Sun

Abstract Aim: the aims of this study were to identify the 5-year mortality rate after hip fracture, identify factors associated with this mortality, and identify the cause of death in these patients.Materials and Methods: A retrospective cohort study of geriatric patients (≥60 years of age) undergoing a hip fracture surgical procedure admitted to our institution between the 1 January 2012 and 31 December 2016 was performed. Demographic and clinical characteristics were collected. Patients or their careers were contacted by telephone or outpatient to ascertain their vital status, and cause of death if they had died at 5-year post-surgery. According to whether they were alive or death at 5-year post-surgery, patients were divided into survivor or non-survivor group. All variables including demographic data and clinical characteristics were compared for both survivors and non-survivors. Cox proportional hazards were used to determine independent risk factors for 5-year mortality. All cause of 5-year mortality in hip fracture were recorded.Result: A total of 327 patients with a median age of 80.00 years were included. 5-year mortality was 40.1%, and the death peak was concentrated during 6 months after surgery. The final multivariate model included 4 independent mortality risk factors: advanced age, stroke, albumin, delayed surgery, with an HR (95% confidence interval) 1.052(1.025-1.080), 1.612(1.104-2.353), 0.940(0.900-0.982), 1.638(1.072-2.498), respectively. Pulmonary infection, and cardiovascular disease were the most common cause of 5-year death.Conclusion: Our results showed that 5-year mortality was 40.1%. Advanced age, stroke, low albumin, and delayed surgery were associated with 5-year mortality after hip fracture surgery. Pulmonary infection, and cardiovascular disease were the most common cause of death.


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