Published online Oct 18, 2021. doi: 10.5312/wjo.v12.i10.751
Peer-review started: March 24, 2021
First decision: June 16, 2021
Revised: June 17, 2021
Accepted: August 18, 2021
Article in press: August 18, 2021
Published online: October 18, 2021
Processing time: 203 Days and 16.6 Hours
From February 2020 onwards, our country has been hit by the coronavirus severe acute respiratory syndrome-2 (SARS-CoV-2) infection. At a glance, hospitals became overrun and had to reformulate all the assistance guidelines, focusing on the coronavirus disease 2019. One year after the start of the pandemic, we present the results of a morbimortality study.
To analyze how our department was affected by the outbreak in terms of morbimortality, and to analyze demographic data, admission to hospital-related data, and subgroups analyses for patients with hip fractures and polytrauma.
We designed a study comparing data from patients who were admitted to our unit due to a lower limb fracture or a high energy trauma during the pandemic (from March to April 2020) to those admitted during the same period in 2019 before the pandemic. during the pandemic situation. Both cohorts completed a minimum of 6 mo of follow-up.
The number of patients admitted to hospital in 2020 was nearly half of those in 2019. Hip fractures in the elderly represented 52 out of 73 of the admitted patients. Twenty patients had a positive test result for SARS-CoV-2 infection. Patients with SARS-CoV-2 infection were admitted to the hospital for a longer time than the non-infected (P < 0.001), and had a higher mortality rate during hospitalization and follow-up (P = 0.02). Patients with a hip fracture associated with a severe respiratory syndrome were mostly selected for conservative treatment (P = 0.03).
Mortality and readmission rates were higher in the 2020 cohort and during follow-up, in comparison with the cohort in 2019.
Core Tip: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was not a criterion for choosing conservative treatment, unless those patients infected with the virus had a poor general condition that made surgery unadvisable. We did not find a relationship between the employment of anticoagulant therapy and the severity of coronavirus disease 2019 (COVID-19) infection or a different mortality rate. Patients who died during hospitalization due to COVID-19 had higher C-reactive protein levels (P < 0.001) and higher urea levels (P = 0.006). The mortality rate in 2020 was 13.7% during hospitalization; 19% during the first month after discharge, and 24.6% in the 3 mo after discharge. The mortality rate in the COVID-19 positive patient subgroup was 38.9% after 6 mo of follow-up. Non-operative treatment in hip fractures was related to SARS-CoV-2 infection (P = 0.03) and with AO 31.B fractures. Polytrauma patients and high energy fractures were more common in 2019 (24%) than in 2020 (11.5%). The main difference between both periods was the injury mechanism.