Summary: To review 30 day mortality rate, mortality related to covid infected neck of femur fracture patients, if we are following NICE guidelines for management of neck of femur fracture patients during the pandemic

Covid-19 has had a profound impact on the NHS.
•In addition, Hip fractures still form a significant proportion of admissions during the national lockdown period in 2020.
•Since 2007 the NHFD has reported a progressive improvement in 30 day mortality after hip fracture and this trend continues with just 6.1% dying in 2018, against 6.9% in 2017.(1)
•Covid-19 has increased the mortality especially in elderly population who commonly present with fragility hip fractures.(2)
•Various early studies show increased mortality in paientswith hip fracture with concurrent covid-19 infection.
National Institute of Clinical Excellence (NICE) clinical guidance (CG124) states that patients should have definitive surgery on the day of, or the day after diagnosis, along with other criteria, aiming to reduce mortality and morbidity.(8)

Objectives

To review the 30 day mortality rate (30 days from fracture diagnosis) in patients with NOFs and PPs during the pandemic.
•To determine mortality in NOF patients with concurrent covid-19 infection.
•To assess if we are following the NICE guidelines of time to surgery for NOF patients during the covidpandemic.

Study Design & Methods

Retrospective study of all patients with NOFs and peri-prosthetic hip and knee fractures admitted during the period of 01/03/2019 to 24/05/2019 and 01/03/2020 to 24/05/2020.
•Data collection using eTrauma, ICE and PACS.

Results

Admissions-
1)There were 86 NOFs in 2019 and 8 PPs in 2019 (94 patients).
2)There were 95 NOFs in 2020 and 9 PPs in 2020 (104 patients).
•Deaths-
1)There were 3 NOF and 1PP deaths in 2019 (4.25%).
2)There were 18NOF deaths and 0 PP deathsin 2020 (17.3%).
•Covid status-
1)Among the 95 NOFs in 2020, 15 were covid positive, of which 7 died.
2)Among the 9 PPs in 2020, there were 2 were covid positive, of which none died.
(38.8% of deaths in 2020 were covid positive)
•Time to surgery for all patients (in 2019 and 2020) was <24 hours.

Conclusions

Mortality rate in 2019 was 4.25% which increased to 17.3% in 2020 which is opposite to the recent yearly decreasing NHFD trend (6.8% prior to pandemic) but similar to NW study (32.8%).
•Of the 2020 deaths, 38.8% were covid-19 positive which is similar torecent UK study of 16,749 patients admitted to hospital with COVID-19 reports a mortality rate of 31%.(9)
•Time to surgery was <24 hours in both 2019 and 2020 showing that we are following NICE guideline.

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Can Hip Microinstability Be Predicted By Hip Range Of Motion Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Justin Hopkins, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Andrea Finlay, PhD, UNITED STATES Nicole Segovia Pham, MPH, UNITED STATES
The Effect Of Osteochondroplasty On Time To Reoperation After Arthroscopic Management Of Femoroacetabular Impingement Abstract Presentation 5 minutes Jeffrey Kay, MD, CANADA Nicole Simunovic, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Efficacy Of Tranexamic Acid In Hip Fracture Surgeries ePoster Presentation Aabid Sanaullah, MBBS,MRCS,MRCPS,PGDipTrauma Surg.FEBOT,FRCSTr&Orth, UNITED KINGDOM Adeel Nawab Ditta, MBBS, MRCS, UNITED KINGDOM Olufunso Damilare Onayemi, MRCS MCH (Ortho), UNITED KINGDOM Ahsan Sheeraz, BSc MBBS MRCS, UNITED KINGDOM Atif A. Malik, MB ChB, MRCS Ed, MSc. (Orto. Eng), FRCS Tr & Orth, UNITED KINGDOM
Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged? Abstract Presentation 5 minutes Gen Lin Foo, MD, SINGAPORE Catherine J. Bacon, PhD, MSc, BSc, BPhed(Hons), NEW ZEALAND Matthew J. Brick, MBChB, FRACS, NEW ZEALAND
Mid-Term Outcome and Strength Assessment after Proximal Rectus-Femoris-Refixation in Athletes ePoster Presentation Maximilian Hinz, MD, GERMANY Stephanie Geyer, MD, GERMANY Felix Winden, Cand Med, GERMANY Alexander Braunsperger, B.Sc., GERMANY Florian Kreuzpointner, PhD, GERMANY Benjamin Daniel Kleim, MBBS, MD, MRes, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Julian Mehl, MD, GERMANY
Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Panagiota Vlaserou, BSc in Physiotherapy, MSc Biomedical Engineer, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Ioannis K. Antonopoulos, GREECE Vassilis N. Psychoyios, MD, GREECE Theodoros G. Troupis, Prof, GREECE
Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics Abstract Presentation 5 minutes Bruno Capurro, MD, PhD., SPAIN Marc Tey Pons, MD, PhD, MScs, SPAIN Francisco Reina, MD, PhD, SPAIN Anna Carrera, MD, PhD., SPAIN Mauricio Gidi, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis Abstract Presentation 9 minutes Casey Wang, MD, CANADA Dan Cohen, MD, CANADA Jeffrey Kay, MD, CANADA Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Carlomagno Cardenas-Nylander, MD, SPAIN Anil S. Ranawat, MD, UNITED STATES Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA
Assessing Risk Of Osteonecrosis Of The Hip Following Intraarticular Injections: Hyaluronic Acid Versus Corticosteroid Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain? Abstract Presentation 5 minutes Daniel Curtis, MD, UNITED STATES William Michael Pullen, MD, UNITED STATES Christopher Jamero, MA, ATC, UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES
Outcome Measures After Proximal Hamstring Repair: A Systematic Review ePoster Presentation Tara Reza, MPH, UNITED STATES Andre Gordon Perez-Chaumont, BS, UNITED STATES Andrew J Hinkle, BS, UNITED STATES Symone M Brown, MPH, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES
Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Jennifer Kurowicki, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Edward Milman, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES
Endoscopic Iliopsoas Lengthening For Treatment Of Recalcitrant Iliopsoas Tendinitis After Total Hip Arthroplasty Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES John Carlo Bonano, MD, UNITED STATES Christopher Jamero, MA, ATC, UNITED STATES Nicole Segovia Pham, MPH, UNITED STATES James I. Huddleston, MD, UNITED STATES
Alpha Angle More Useful Than Femoral Head-Neck Offset to Predict Intra-Articular Damage in Patients with FAI Undergoing Hip Arthroscopy Abstract Presentation 5 minutes Jacob Shapira, MD, UNITED STATES Jade S Owens, BS, UNITED STATES David R. Maldonado, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Bezalel Peskin, MD, ISRAEL Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Cannabis Use Is Not Associated With Increased Opioid Use Or Costs After Hip Arthroscopy Abstract Presentation 5 minutes Christopher L. McCrum, MD, UNITED STATES Jacob Thomas Wood, BS, UNITED STATES Senthil Sambandam, MD, UNITED STATES

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Covid Mortality Among Neck Of Femur Fractures During The Pandemic 2019

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Covid Mortality Among Neck Of Femur Fractures During The Pandemic 2019

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More ISAKOS 2021: Global Content