Short-term Outcomes of Patients with Fragility Hip Fractures Infected with SARS-CoV-2 Managed in a COVID-19 Referral Hospital with an Orthogeriatric Team

Abstract

Objectives. Presence of COVID-19 infection in patients with acute fragility hip fracture complicates the decision-making process in the management of these patients. This study aims to describe outcomes of patients with coexisting fragility hip fracture and COVID-19 infection who underwent surgery.

Methods. In this retrospective study, the patient database of a university hospital designated as a COVID-19 referral center with an orthogeriatric team was reviewed to determine the mortality and morbidity rates, and short-term functional outcomes of patients with coexisting COVID-19 and acute fragility hip fracture who underwent surgery.

Results. A total of 18 patients were admitted with COVID-19 infection and acute fragility hip fracture – 12 had
surgery. Mean injury-to-admission and admission-to-surgery intervals were 6.5 and 4.8 days, respectively. Most
patients (91.7%) had an incidental finding of SARS-CoV-2 infection. Mean ASA score was 2.9. Arthroplasty was
done in all patients with a mean operative time of 155.8 minutes and an average blood loss of 366.7 mL. Thirty-day mortality and morbidity rates were 16.7% and 33.3%, respectively. Mean EuroQoL overall health score was 79.3.

Conclusion. A multidisciplinary team approach is recommended to expedite timely surgery prior to the onset of
clinical deterioration. Asymptomatic and mildly symptomatic patients with acute fragility hip fracture are candidates for urgent surgical intervention even in the presence of COVID-19 infection