DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY

Sonu Mehta; Llinos Williams; Uday Mahajan; Deepu Bhaskar; Sameer Rathore; Victoria Barlow; Peter Leggetter

doi:10.1302/1358-992X.2023.16.002

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DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY

The British Orthopaedic Research Society (BORS) 2023 Meeting, Cambridge, England, 25–26 September 2023.

Sonu Mehta
Llinos Williams
Uday Mahajan
Deepu Bhaskar
Sameer Rathore
Victoria Barlow
Peter Leggetter

DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY

Mehta S, Williams L, Mahajan U, et al. DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY. Orthop Procs. 2023;105-B(SUPP_16):2-2. doi:10.1302/1358-992X.2023.16.002

Mehta, Sonu, et al. “DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY.” Orthopaedic Proceedings, vol. 105-B, no. SUPP_16, 2023, pp. 2-2., https://doi.org/10.1302/1358-992X.2023.16.002

Mehta, S., Williams, L., Mahajan, U., Bhaskar, D., Rathore, S., Barlow, V., & Leggetter, P. (2023). DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY. Orthopaedic Proceedings, 105-B(SUPP_16), 2-2. https://doi.org/10.1302/1358-992X.2023.16.002

Mehta, S., Williams, L., Mahajan, U., Bhaskar, D., Rathore, S., Barlow, V. et al. (2023) “DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY.” Orthopaedic Proceedings, 105-B(SUPP_16), pp. 2-2. Available at: https://doi.org/10.1302/1358-992X.2023.16.002

Mehta, Sonu, Llinos Williams, Uday Mahajan, Deepu Bhaskar, Sameer Rathore, Victoria Barlow, and Peter Leggetter. “DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY.” Orthopaedic Proceedings 105-B, no. SUPP_16 (2023): 2-2. https://doi.org/10.1302/1358-992X.2023.16.002

Mehta S, Williams L, Mahajan U, Bhaskar D, Rathore S, Barlow V, et al. DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY. Orthop Procs. 2023 Nov 17;105-B(SUPP_16):2-2. https://doi.org/10.1302/1358-992X.2023.16.002

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Abstract

Introduction

Several studies have shown that patients over 65 years have a higher mortality with covid. Combine with inherently increased morbidity and mortality in neck of femur (NoFF) fractures, it is logical to think that this subset would be most at risk.

Aims

Investigate whether there is actual increase in direct mortality from Covid infection in NoFF patients, also investigate other contributing factors to mortality with covid positivity and compare the findings with current available literature.

Methods

1-year cross sectional, retrospective study from 1st March 2020 at two DGHs, one in Wales and one in England. Surgically treated NoFF patients with isolated intra/extracapsular fracture included. Mortality analysis done by creating a matched comparison group for each risk factor and combinations known to confer highest mortality. Chi square test for independence used to compare COVID status with 1 year mortality.

Results

610 patients, 62 patients had COVID-19RTPCR+ive test during hospital stay/in the community. 21(34%) deaths in COVID positive and 95 (17.33%) deaths in COVID negative patients. There was no mortality in ASA 1 or 2 patients. Analysis of asa matching with 10-year age ranges from 65years revealed a nearly double mortality rate in covid+ group as opposed to covid negative for both ASA 3 and 4 groups. Parameters such as preinjury mobility, residential status, AMTS score, time to surgery, did not seem to play a significant role in mortality.

Conclusion

First of its kind study with a large subset of patients and unique parameters to identify causes leading to mortality in the vulnerable population of NoFF. Higher morality in Covid positive NoFF patients, but increase may not be as significant as identified by most current studies in the literature and still within the confines of NHFD stats(2019).

Declaration of Interest

(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.