COVID Delivers Rare Insights Into Hip Fracture Care

Researchers at Hospital for Special Surgery (HSS) recently examined how the COVID-19 pandemic affected hip fracture patient outcomes. According to their data, hospitals may want to re-evaluate their traditional care for these patients.

“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.

Memtsoudis and colleagues also compared the characteristics and outcomes of hip fracture patients with and without the virus. The findings were presented at the 2021 Spring American Society of Regional Anesthesia and Pain Medicine Annual Meeting.

Data on patients was collected from March to April 2019 and March to April 2020. Primary outcomes included length of hospital stay, admission to an intensive care unit, use of mechanical ventilation, 30-day readmission, discharge disposition and postoperative complications.

Overall, the number of hip fracture cases during COVID-19 decreased by 50% compared to the same time period the year before. And those patients who were admitted to the hospital were discharged earlier and were less likely to be admitted to the intensive care unit.

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

Some factors like in-hospital mortality rate, 30-day readmission rate, use of mechanical ventilation and complication rate, however, did not change.

“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 added.

When it came to hip-fracture patients with COVID-19, though, the researchers found they did stay in the hospital longer, had higher rates of complications during surgery, increased rates of mortality and were more likely to receive nonsurgical treatment.

They advise hospitals to have plans in place for treating hip fracture patients with COVID-19 while still protecting other patients from exposure. Hip fracture cases are expected to increase again as COVID-19 restrictions are lessened, they said.

The researchers also noted that their findings should raise the question of whether traditional strategies of care for these patients should be reevaluated. Shorter length of stay in the hospital, less use of ICU and earlier home discharge didn’t negatively affect outcomes and should be studied further, they said.