Background. Hip fracture in the elderly has high morbidity and mortality. National guidelines have recommended low molecular weight (LMW) heparin or aspirin for thromboprophylaxis in hip fracture. Unlike other types of major surgery, there is a lack of trial evidence for graduated elasticated compression (GEC) stockings in hip fracture patients. Objective. To explore the effect of thromboprophylaxis on survival in hip fracture patients. Participants. 8470 Scottish Hip Fracture Audit (SHFA) participants aged 60 years and over, admitted 1998-2003. Methods. SHFA records were linked to routinely collected hospital discharge and death records occurring within one year of hip fracture admission. Cox proportional hazards regression was used to adjust for age, gender, previous hospital admissions, previous walking ability and residence, American Society of Anesthesiologists grade, fracture type, pressure sores prior to surgery, and delay to surgery. Results. 2531 (30%) patients died within one year of hip fracture admission. GEC stockings appeared to be protective against death (hazard ratio 0.88, 95% confidence interval 0.80-0.97) as did aspirin (HR 0.85, 95% CI 0.76-0.95). However heparin did not appear to protect against death (HR 0.97, 95% CI 0.87-1.08), even when only LMW heparin was included in the analysis. Overall, 3318 (39%) patients were given GEC stockings, 2735 (32%) aspirin, and 4527 (53%) heparin. Patients commonly received more than one type of thromboprophylaxis. Conclusions. This study provides evidence for a protective effect of GEC stockings and aspirin following hip fracture, but not heparin. The study design allowed sophisticated analysis, adjusting for a number of functional, social, surgical, anaesthetic and medical factors. The findings may however be explained by other confounding factors not included in the analysis. These findings suggest that a randomised controlled trial of GEC stockings, aspirin and heparin in hip fracture patients is warranted

Aims

The primary aim of this study was to assess the independent association of the coronavirus disease 2019 (COVID-19) on postoperative mortality for patients undergoing orthopaedic and trauma surgery. The secondary aim was to identify factors that were associated with developing COVID-19 during the postoperative period.