Aims: This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods: A multicentre collaboration among 112 centres in 14 countries collected data on all patients presenting with a hip fracture between 1st March-31st May 2020. Demographics, residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, management, ASA grade, length of stay, COVID-19 and 30-day mortality status were recorded. Results: A total of 7090 patients were included, with a mean age of 82.2 (range 50–104) years and 4959 (69.9%) being female. Of 651 (9.2%) patients diagnosed with COVID-19, 225 (34.6%) were positive at presentation and 426 (65.4%) were positive postoperatively. Positive COVID-19 status was independently associated with male sex (odds ratio (OR) 1.38, p = 0.001), residential care (OR 2.15, p < 0.001), inpatient fall (OR 2.23, p = 0.003), cancer (OR 0.63, p = 0.009), ASA grades 4 (OR 1.59, p = 0.008) or 5 (OR 8.28, p < 0.001), and longer admission (OR 1.06 for each increasing day, p < 0.001). Patients with COVID-19 at any time had a significantly lower chance of 30-day survival versus those without COVID-19 (72.7% versus 92.6%, p < 0.001). COVID-19 was independently associated with an increased 30-day mortality risk (hazard ratio (HR) 2.83, p < 0.001). Increasing age (HR 1.03, p = 0.028), male sex (HR 2.35, p < 0.001), renal disease (HR 1.53, p = 0.017), and pulmonary disease (HR 1.45, p = 0.039) were independently associated with a higher 30-day mortality risk in patients with COVID-19 when adjusting for confounders. Conclusion: The prevalence of COVID-19 in hip fracture patients during the first wave of the pandemic was 9%, and was independently associated with a three-fold increased 30-day mortality risk. Among COVID-19-positive patients, those who were older, male, with renal or pulmonary disease had a significantly higher 30-day mortality risk.

Hall, A., Clement, N., Ojeda-Thies, C., Maclullich, A., Toro, G., Johansen, A., et al. (2022). IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic. SURGEON [10.1016/j.surge.2022.02.009].

IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic

Bellelli, Giuseppe
Membro del Collaboration Group
;
Zatti, Giovanni
Membro del Collaboration Group
;
2022

Abstract

Aims: This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods: A multicentre collaboration among 112 centres in 14 countries collected data on all patients presenting with a hip fracture between 1st March-31st May 2020. Demographics, residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, management, ASA grade, length of stay, COVID-19 and 30-day mortality status were recorded. Results: A total of 7090 patients were included, with a mean age of 82.2 (range 50–104) years and 4959 (69.9%) being female. Of 651 (9.2%) patients diagnosed with COVID-19, 225 (34.6%) were positive at presentation and 426 (65.4%) were positive postoperatively. Positive COVID-19 status was independently associated with male sex (odds ratio (OR) 1.38, p = 0.001), residential care (OR 2.15, p < 0.001), inpatient fall (OR 2.23, p = 0.003), cancer (OR 0.63, p = 0.009), ASA grades 4 (OR 1.59, p = 0.008) or 5 (OR 8.28, p < 0.001), and longer admission (OR 1.06 for each increasing day, p < 0.001). Patients with COVID-19 at any time had a significantly lower chance of 30-day survival versus those without COVID-19 (72.7% versus 92.6%, p < 0.001). COVID-19 was independently associated with an increased 30-day mortality risk (hazard ratio (HR) 2.83, p < 0.001). Increasing age (HR 1.03, p = 0.028), male sex (HR 2.35, p < 0.001), renal disease (HR 1.53, p = 0.017), and pulmonary disease (HR 1.45, p = 0.039) were independently associated with a higher 30-day mortality risk in patients with COVID-19 when adjusting for confounders. Conclusion: The prevalence of COVID-19 in hip fracture patients during the first wave of the pandemic was 9%, and was independently associated with a three-fold increased 30-day mortality risk. Among COVID-19-positive patients, those who were older, male, with renal or pulmonary disease had a significantly higher 30-day mortality risk.
Articolo in rivista - Articolo scientifico
Audit; Communicable disease; COVID-19; Frailty; Geriatric; Hip fracture; Infection; Meta-audit; Nosocomial; Orthopaedic; Outcomes; Prognosis; Reporting standards; Risk; Trauma;
English
Zatti, Giovanni e Belelli, Giuseppe IMPACT-Global Group
Hall, A., Clement, N., Ojeda-Thies, C., Maclullich, A., Toro, G., Johansen, A., et al. (2022). IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic. SURGEON [10.1016/j.surge.2022.02.009].
Hall, A; Clement, N; Ojeda-Thies, C; Maclullich, A; Toro, G; Johansen, A; White, T; Duckworth, A; Abdul-Jabar, H; Abu-Rajab, R; Abugarja, A; Adam, K; Aguado Hernández, H; Améstica Lazcano, G; Anderson, S; Ansar, M; Antrobus, J; Aragón Achig, E; Archunan, M; Arrieta Salinas, M; Ashford-Wilson, S; Assens Gibert, C; Athanasopoulou, K; Awadelkarim, M; Baird, S; Bajada, S; Balakrishnan, S; Balasubramanian, S; Ballantyne, J; Bárcena Goitiandia, L; Barkham, B; Barmpagianni, C; Barres-Carsi, M; Barrett, S; Baskaran, D; Bell, J; Bell, K; Bell, S; Bellelli, G; Benchimol, J; Boietti, B; Boswell, S; Braile, A; Brennan, C; Brent, L; Brooke, B; Bruno, G; Burahee, A; Burns, S; Calabrò, G; Campbell, L; Carabelli, G; Carnegie, C; Carretero Cristobal, G; Caruana, E; Cassinello Ogea, M; Castellanos Robles, J; Castillon, P; Chakrabarti, A; Cecere, A; Chen, P; Clarke, J; Collins, G; Corrales Cardenal, J; Corsi, M; Cózar Adelantado, G; Craxford, S; Crooks, M; Cuarental-García, J; Cuthbert, R; Dall, G; Daskalakis, I; De Cicco, A; Diana, D; Demaria, P; Dereix, J; Díaz Jiménez, J; Dinamarca Montecinos, J; Do Le, H; Donoso Coppa, J; Drosos, G; Duffy, A; East, J; Eastwood, D; Elbahari, H; Elias de Molins Peña, C; Elmamoun, M; Emmerson, B; Escobar Sánchez, D; Faimali, M; Farré-Mercadé, M; Farrow, L; Fayez, A; Fell, A; Fenner, C; Ferguson, D; Finlayson, L; Flores Gómez, A; Freeman, N; French, J; Gabardo Calvo, S; Gagliardo, N; Garcia Albiñana, J; García Cruz, G; García de Cortázar Antolín, U; García Virto, V; Gealy, S; Gil Caballero, S; Gill, M; González González, M; Gopireddy, R; Guntley, D; Gurung, B; Guzmán Rosales, G; Haddad, N; Hafeez, M; Haller, P; Halligan, E; Hardie, J; Hawker, I; Helal, A; Herrera Cruz, M; Herreros Ruiz-Valdepeñas, R; Horton, J; Howells, S; Howieson, A; Hughes, L; Hünicken Torrez, F; Hurtado Ortega, A; Huxley, P; Hamid, H; Ilahi, N; Iliadis, A; Inman, D; Jadhao, P; Jandoo, R; Jawad, L; Jayatilaka, M; Jenkins, P; Jeyapalan, R; Johnson, D; Johnston, A; Joseph, S; Kapoor, S; Karagiannidis, G; Karanam, K; Kattakayam, F; Konarski, A; Kontakis, G; Labrador Hernández, G; Lancaster, V; Landi, G; Le, B; Liew, I; Logishetty, K; Lopez Marquez, A; Lopez, J; Lum, J; Macpherson, G; Madan, S; Mahroof, S; Malik-Tabassum, K; Mallina, R; Maqsood, A; Marson, B; Martin Legorburo, M; Martin-Perez, E; Martínez Jiménez, T; Martinez Martin, J; Mayne, A; Mayor, A; Mcalinden, G; Mclean, L; Mcdonald, L; Mcintyre, J; Mckay, P; Mckean, G; Mcshane, H; Medici, A; Meeke, C; Meldrum, E; Mendez, M; Mercer, S; Merino Perez, J; Mesa-Lampré, M; Mighton, S; Milne, K; Mohamed Yaseen, M; Moppett, I; Mora, J; Morales-Zumel, S; Moreno Fenoll, I; Mousa, A; Murray, A; Murray, E; Nair, R; Neary, F; Negri, G; Negus, O; Newham-Harvey, F; Ng, N; Nightingale, J; Noor Mohamed Anver, S; Nunag, P; O'Hare, M; Ollivere, B; Ortés Gómez, R; Owens, A; Page, S; Palloni, V; Panagiotopoulos, A; Panagiotopoulos, E; Panesar, P; Papadopoulos, A; Spyridon, P; Pareja Sierra, T; Park, C; Parwaiz, H; Paterson-Byrne, P; Patton, S; Pearce, J; Porter, M; Pellegrino, A; Pèrez Cuellar, A; Pezzella, R; Phadnis, A; Pinder, C; Piper, D; Powell-Bowns, M; Prieto Martín, R; Probert, A; Ramesh, A; Ramírez de Arellano, M; Renton, D; Rickman, S; Robertson, A; Roche Albero, A; Rodrigo Verguizas, J; Rodríguez Couso, M; Rooney, J; Sáez-López, P; Saldaña-Díaz, A; Santulli, A; Sanz Pérez, M; Sarraf, K; Scarsbrook, C; Scott, C; Scott, J; Shah, S; Sharaf, S; Sharma, S; Shirley, D; Siano, A; Simpson, J; Singh, A; Singh, A; Sinnett, T; Sisodia, G; Smith, P; Sophena Bert, E; Steel, M; Stewart, A; Stewart, C; Sugand, K; Sullivan, N; Sweeting, L; Symes, M; Tan, D; Tancredi, F; Tatani, I; Thomas, P; Thomson, F; Toner, N; Tong, A; Toro, A; Tosounidis, T; Tottas, S; Trinidad Leo, A; Tucker, D; Vemulapalli, K; Ventura Garces, D; Vernon, O; Viveros Garcia, J; Ward, A; Ward, K; Watson, K; Weerasuriya, T; Wickramanayake, U; Wilkinson, H; Windley, J; Wood, J; Wynell-Mayow, W; Zatti, G; Zeiton, M; Zurrón Lobato, M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/364797
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