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
Kiko A. Cortez, MD; Irewin A. Tabu, MD, FPOA
Hip fractures in the elderly population is a significant cause of mortality and morbidity, with a huge economic impact to the healthcare system. Perioperative presence of COVID-19 infection in patients with acute fragility hip fracture complicates the decision-making process in the management of these patients. In this ambispective study, the patient database of a COVID-19 referral hospital 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. A total of 17 patients were admitted with preoperative COVID-19 infection and acute fragility hip fracture – 10 of which had surgery. Mean injury-to-admission and admission-to-surgery intervals were 7.0 and 4.6 days, respectively. Joint replacement procedures were done in all patients with a mean operative time of 162.9 minutes and an average blood loss of 395 ml. Thirty-day mortality and morbidity rates were 10% and 30%, respectively. Mean EuroQoL overall health score at short-term follow-up was 81.4. A multidisciplinary orthogeriatric team approach should be employed to expedite timely surgical intervention prior to the development of secondary complications and clinical deterioration, as well as to achieve the best outcomes in patients with coexisting asymptomatic and mild COVID-19 infection and acute fragility hip fracture.