Hip Fracture Surgeries Decreased During COVID-19

A new study from the Hospital for Special Surgery (HSS) finds that hip fracture surgeries have decreased by 50% during the COVID-19 pandemic.

Hip fractures are primarily seen in the elderly. The researchers say this suggests rates of hip fractures will likely increase back to pre-pandemic levels as people gradual return to normal activity. Hospitals, they say, should have a plan in place to handle the influx as well as a plan to protect non-COVID-19 patients from exposure.

“Studying this topic is important because events that stress the healthcare system, like this pandemic, allow us to gain rare insights into what happens to medical care when resources become scarce,” said Stavros Memtsoudis, M.D., Ph.D., M.B.A., an anesthesiologist at HSS.

In the study which was presented at the 2021 American Society of Regional Anesthesia and Pain Medicine Annual Meeting, the researchers compared patient and healthcare characteristics, COVID-19 diagnoses and outcomes for hip-fracture patients from March to April 2019 and March to April 2020.

Primary outcomes were length of hospital stay, admission to an intensive care unit, use of mechanical ventilation, 30-day readmission, discharge disposition and postoperative complications.

“One of the major takeaways from this study was we saw that fractures were more commonly treated nonoperatively, and how outcomes differed,” Dr. Memtsoudis said.

He noted that during the pandemic, hip fracture patients were discharged earlier and were less likely to be admitted to the ICU. In-hospital mortality rate, 30-day readmission rate, use of mechanical ventilation, and complication rate, however, did not differ before or after COVID-19.

Hip-fracture patients with COVID-19 tended to stay in the hospital longer, had higher rates of complications during surgery, increased rates of mortality, and more frequently received nonsurgical treatment.

They also found that shorter length of stay in the hospital, less ICU time and earlier discharge did not affect outcomes adversely. They suggest that these practices might be better to continue even after the pandemic.

“These results should make us reevaluate our practice going forward to make sure we do not waste resources but also affirm interventions that truly are beneficial,” Dr. Memtsoudis said.