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Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients’ clinical presentation and comorbidity: a multicentric study in Northern Italy
Purpose This study aims to evaluate 30–60–90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients’ clinical presentation and comorbidities. Methods Between February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgica...
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| Published in: | International orthopaedics 2021-10, Vol.45 (10), p.2499-2505 |
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| creator | Fusini, Federico Massè, Alessandro Risitano, Salvatore Ferrera, Andrea Enrietti, Emilio Zoccola, Kristijan Bianco, Giuseppe Zanchini, Fabio Colò, Gabriele |
| description | Purpose
This study aims to evaluate 30–60–90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients’ clinical presentation and comorbidities.
Methods
Between February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgically treated PFF were included. Patients’ demographic characteristics, oxygen (O2) therapy, comorbidities, and AO type fracture were collected. Chi-square test or Fisher test and hazard ratio were used to assessing the correlation between mortality rate, patient characteristics, and COVID-19 status. Kaplan-Meyer curve was used to analyze 30–60–90-day mortality. Level of significance was set as
p
|
| doi_str_mv | 10.1007/s00264-021-05166-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8366488</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2562235514</sourcerecordid><originalsourceid>FETCH-LOGICAL-c446t-17b24501aa6801f3024828af98b1a35e58ed4c56a98e2a2a12c376f91712436a3</originalsourceid><addsrcrecordid>eNp9Ustu1DAUjRCIDoUfYIHukgUBv-JJWICq4TVSRRc8ttadxOm48tjBdmiz4zfY8S18Cl_AJ-B02go2rK7se16yT1E8pOQpJWT5LBLCpCgJoyWpqJQlv1UsqOCsrGhT3S4WhAtaMtlUB8W9GM8IoUtZ07vFAReC0IbTRfH7w9aPtoNzDX7QAZP--cM7QGthwGS0SxHOTdrC6uTz-lVJG0DXwRD8hdmhhV7vfJhnwDaNQceXcJTZDu0UTQTfQ9qakKYnEM3FPGa2M06nCTqcILMTWpNPs3WEDUbdQQ5wbf7r23dorXGmzS5DNsiXeTVHzEqtzwIb02WB54CwG20ybUYE00JMYzeBcfA-e2x1cLDOVtP94k6PNuoHV_Ow-PTm9cfVu_L45O16dXRctkLIVNLlhomKUERZE9pzwkTNauybekORV7qqdSfaSmJTa4YMKWv5UvYNXVImuER-WLzY6w7jZqe7y1Ro1RDyu4VJeTTq340zW3Xqv6qaSynqOgs8vhII_suoY1I7E1ttLTrtx6hYJRnjVZU__LBge2gbfIxB9zc2lKi5KmpfFZWroi6rongmPfo74A3luhsZwPeAmFfuVAd15seQvzb-T_YPGDvRkg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2562235514</pqid></control><display><type>article</type><title>Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients’ clinical presentation and comorbidity: a multicentric study in Northern Italy</title><source>Springer Nature</source><creator>Fusini, Federico ; Massè, Alessandro ; Risitano, Salvatore ; Ferrera, Andrea ; Enrietti, Emilio ; Zoccola, Kristijan ; Bianco, Giuseppe ; Zanchini, Fabio ; Colò, Gabriele</creator><creatorcontrib>Fusini, Federico ; Massè, Alessandro ; Risitano, Salvatore ; Ferrera, Andrea ; Enrietti, Emilio ; Zoccola, Kristijan ; Bianco, Giuseppe ; Zanchini, Fabio ; Colò, Gabriele</creatorcontrib><description>Purpose
This study aims to evaluate 30–60–90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients’ clinical presentation and comorbidities.
Methods
Between February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgically treated PFF were included. Patients’ demographic characteristics, oxygen (O2) therapy, comorbidities, and AO type fracture were collected. Chi-square test or Fisher test and hazard ratio were used to assessing the correlation between mortality rate, patient characteristics, and COVID-19 status. Kaplan-Meyer curve was used to analyze 30–60–90-day mortality. Level of significance was set as
p
< 0.05.
Results
Fifty-six patients (mean age of 82.7 ± 8.85 years) were included. Thirty-day mortality rate was 5%, which increased to 21% at 60 days and 90 days. Eleven patients died, eight due to AO type A-like and three due to AO type B-like fractures. No significant difference in mortality rate between patients with cardiopulmonary comorbidity or no cardiopulmonary comorbidity was found (
p
= 0.67); a significant difference in patients with chronic obstructive pulmonary disease (COPD) or history of pulmonary embolism (PE) and patients without COPD was found (
p
= 0.0021). A significant difference between asymptomatic/mild symptomatic COVID-19 status and symptomatic COVID-19 status was found (
p
= 0.0415); a significant difference was found for O2 therapy with < 4 L/min and O2 therapy ≥ 4 L/min (
p
= 0.0049).
Conclusion
Thirty-day mortality rate of COVID-19 infection and PFFs does not differ from mortality rate of non-COVID-19 PFFs. However, patients with pre-existing comorbidities and symptomatic COVID-19 infection requiring a high volume of O2 therapy have a higher incidence of 60–90-day mortality when surgically treated.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-021-05166-3</identifier><identifier>PMID: 34401931</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Comorbidity ; COVID-19 ; Femoral Fractures - epidemiology ; Femoral Fractures - surgery ; Hip Fractures ; Humans ; Italy - epidemiology ; Medicine ; Medicine & Public Health ; Original Paper ; Orthopedics ; Retrospective Studies ; SARS-CoV-2</subject><ispartof>International orthopaedics, 2021-10, Vol.45 (10), p.2499-2505</ispartof><rights>SICOT aisbl 2021</rights><rights>2021. SICOT aisbl.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-17b24501aa6801f3024828af98b1a35e58ed4c56a98e2a2a12c376f91712436a3</citedby><cites>FETCH-LOGICAL-c446t-17b24501aa6801f3024828af98b1a35e58ed4c56a98e2a2a12c376f91712436a3</cites><orcidid>0000-0002-4223-8485</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34401931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fusini, Federico</creatorcontrib><creatorcontrib>Massè, Alessandro</creatorcontrib><creatorcontrib>Risitano, Salvatore</creatorcontrib><creatorcontrib>Ferrera, Andrea</creatorcontrib><creatorcontrib>Enrietti, Emilio</creatorcontrib><creatorcontrib>Zoccola, Kristijan</creatorcontrib><creatorcontrib>Bianco, Giuseppe</creatorcontrib><creatorcontrib>Zanchini, Fabio</creatorcontrib><creatorcontrib>Colò, Gabriele</creatorcontrib><title>Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients’ clinical presentation and comorbidity: a multicentric study in Northern Italy</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Purpose
This study aims to evaluate 30–60–90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients’ clinical presentation and comorbidities.
Methods
Between February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgically treated PFF were included. Patients’ demographic characteristics, oxygen (O2) therapy, comorbidities, and AO type fracture were collected. Chi-square test or Fisher test and hazard ratio were used to assessing the correlation between mortality rate, patient characteristics, and COVID-19 status. Kaplan-Meyer curve was used to analyze 30–60–90-day mortality. Level of significance was set as
p
< 0.05.
Results
Fifty-six patients (mean age of 82.7 ± 8.85 years) were included. Thirty-day mortality rate was 5%, which increased to 21% at 60 days and 90 days. Eleven patients died, eight due to AO type A-like and three due to AO type B-like fractures. No significant difference in mortality rate between patients with cardiopulmonary comorbidity or no cardiopulmonary comorbidity was found (
p
= 0.67); a significant difference in patients with chronic obstructive pulmonary disease (COPD) or history of pulmonary embolism (PE) and patients without COPD was found (
p
= 0.0021). A significant difference between asymptomatic/mild symptomatic COVID-19 status and symptomatic COVID-19 status was found (
p
= 0.0415); a significant difference was found for O2 therapy with < 4 L/min and O2 therapy ≥ 4 L/min (
p
= 0.0049).
Conclusion
Thirty-day mortality rate of COVID-19 infection and PFFs does not differ from mortality rate of non-COVID-19 PFFs. However, patients with pre-existing comorbidities and symptomatic COVID-19 infection requiring a high volume of O2 therapy have a higher incidence of 60–90-day mortality when surgically treated.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Comorbidity</subject><subject>COVID-19</subject><subject>Femoral Fractures - epidemiology</subject><subject>Femoral Fractures - surgery</subject><subject>Hip Fractures</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9Ustu1DAUjRCIDoUfYIHukgUBv-JJWICq4TVSRRc8ttadxOm48tjBdmiz4zfY8S18Cl_AJ-B02go2rK7se16yT1E8pOQpJWT5LBLCpCgJoyWpqJQlv1UsqOCsrGhT3S4WhAtaMtlUB8W9GM8IoUtZ07vFAReC0IbTRfH7w9aPtoNzDX7QAZP--cM7QGthwGS0SxHOTdrC6uTz-lVJG0DXwRD8hdmhhV7vfJhnwDaNQceXcJTZDu0UTQTfQ9qakKYnEM3FPGa2M06nCTqcILMTWpNPs3WEDUbdQQ5wbf7r23dorXGmzS5DNsiXeTVHzEqtzwIb02WB54CwG20ybUYE00JMYzeBcfA-e2x1cLDOVtP94k6PNuoHV_Ow-PTm9cfVu_L45O16dXRctkLIVNLlhomKUERZE9pzwkTNauybekORV7qqdSfaSmJTa4YMKWv5UvYNXVImuER-WLzY6w7jZqe7y1Ro1RDyu4VJeTTq340zW3Xqv6qaSynqOgs8vhII_suoY1I7E1ttLTrtx6hYJRnjVZU__LBge2gbfIxB9zc2lKi5KmpfFZWroi6rongmPfo74A3luhsZwPeAmFfuVAd15seQvzb-T_YPGDvRkg</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Fusini, Federico</creator><creator>Massè, Alessandro</creator><creator>Risitano, Salvatore</creator><creator>Ferrera, Andrea</creator><creator>Enrietti, Emilio</creator><creator>Zoccola, Kristijan</creator><creator>Bianco, Giuseppe</creator><creator>Zanchini, Fabio</creator><creator>Colò, Gabriele</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4223-8485</orcidid></search><sort><creationdate>20211001</creationdate><title>Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients’ clinical presentation and comorbidity: a multicentric study in Northern Italy</title><author>Fusini, Federico ; Massè, Alessandro ; Risitano, Salvatore ; Ferrera, Andrea ; Enrietti, Emilio ; Zoccola, Kristijan ; Bianco, Giuseppe ; Zanchini, Fabio ; Colò, Gabriele</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-17b24501aa6801f3024828af98b1a35e58ed4c56a98e2a2a12c376f91712436a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Comorbidity</topic><topic>COVID-19</topic><topic>Femoral Fractures - epidemiology</topic><topic>Femoral Fractures - surgery</topic><topic>Hip Fractures</topic><topic>Humans</topic><topic>Italy - epidemiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fusini, Federico</creatorcontrib><creatorcontrib>Massè, Alessandro</creatorcontrib><creatorcontrib>Risitano, Salvatore</creatorcontrib><creatorcontrib>Ferrera, Andrea</creatorcontrib><creatorcontrib>Enrietti, Emilio</creatorcontrib><creatorcontrib>Zoccola, Kristijan</creatorcontrib><creatorcontrib>Bianco, Giuseppe</creatorcontrib><creatorcontrib>Zanchini, Fabio</creatorcontrib><creatorcontrib>Colò, Gabriele</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fusini, Federico</au><au>Massè, Alessandro</au><au>Risitano, Salvatore</au><au>Ferrera, Andrea</au><au>Enrietti, Emilio</au><au>Zoccola, Kristijan</au><au>Bianco, Giuseppe</au><au>Zanchini, Fabio</au><au>Colò, Gabriele</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients’ clinical presentation and comorbidity: a multicentric study in Northern Italy</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>45</volume><issue>10</issue><spage>2499</spage><epage>2505</epage><pages>2499-2505</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Purpose
This study aims to evaluate 30–60–90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients’ clinical presentation and comorbidities.
Methods
Between February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgically treated PFF were included. Patients’ demographic characteristics, oxygen (O2) therapy, comorbidities, and AO type fracture were collected. Chi-square test or Fisher test and hazard ratio were used to assessing the correlation between mortality rate, patient characteristics, and COVID-19 status. Kaplan-Meyer curve was used to analyze 30–60–90-day mortality. Level of significance was set as
p
< 0.05.
Results
Fifty-six patients (mean age of 82.7 ± 8.85 years) were included. Thirty-day mortality rate was 5%, which increased to 21% at 60 days and 90 days. Eleven patients died, eight due to AO type A-like and three due to AO type B-like fractures. No significant difference in mortality rate between patients with cardiopulmonary comorbidity or no cardiopulmonary comorbidity was found (
p
= 0.67); a significant difference in patients with chronic obstructive pulmonary disease (COPD) or history of pulmonary embolism (PE) and patients without COPD was found (
p
= 0.0021). A significant difference between asymptomatic/mild symptomatic COVID-19 status and symptomatic COVID-19 status was found (
p
= 0.0415); a significant difference was found for O2 therapy with < 4 L/min and O2 therapy ≥ 4 L/min (
p
= 0.0049).
Conclusion
Thirty-day mortality rate of COVID-19 infection and PFFs does not differ from mortality rate of non-COVID-19 PFFs. However, patients with pre-existing comorbidities and symptomatic COVID-19 infection requiring a high volume of O2 therapy have a higher incidence of 60–90-day mortality when surgically treated.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34401931</pmid><doi>10.1007/s00264-021-05166-3</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-4223-8485</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8366488 |
| source | Springer Nature |
| subjects | Aged Aged, 80 and over Comorbidity COVID-19 Femoral Fractures - epidemiology Femoral Fractures - surgery Hip Fractures Humans Italy - epidemiology Medicine Medicine & Public Health Original Paper Orthopedics Retrospective Studies SARS-CoV-2 |
| title | Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients’ clinical presentation and comorbidity: a multicentric study in Northern Italy |
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