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Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_2 | Pages 76 - 76
1 Mar 2021
Peters J Wickramarachchi L Thakrar A Chin K Wong J Mazis G Beckles V
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Abstract

Objectives

Our objective was to determine the incidence of post-operative COVID-19 infection within the first two weeks following treatment at the COVID-free site. During the COVID-19 pandemic our hospital saw one of the highest rates of COVID-19 infection in the United Kingdom. As a result, our trauma services were relocated to a vacant private elective hospital to provide a ‘COVID-free’ setting for trauma patients. Patients admitted to the COVID-free site were screened for coronavirus infection and only treated at that site if asymptomatic. Those with symptoms were treated at the ‘COVID’ site.

Method

We collected data at the COVID-free site during the first seven weeks of its’ establishment. Inclusion criteria were all patients presenting for operative management of limb trauma; however, fragility hip fractures were excluded. All patients were screened for symptoms of COVID-19 infection at their 2-week follow-up appointment.


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_2 | Pages 67 - 67
1 Mar 2021
Peters J Thakrar A Wickramarachchi L Acharya A
Full Access

Abstract

Objectives

Our study evaluates financial impact to the Best Practice Tariff (BPT) of hip fracture patients on Novel Oral Anti-Coagulant (NOAC) medication. Since their approval by NICE for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation, the incidence of hip fracture patients admitted to hospitals on NOAC medication (e.g. rivaroxiban, apixaban) has been increasing. BPT for hip fractures has two components: a base tariff and a conditional top-up tariff of £1,335 per patient (applied to patients of 60 years of age). For the top-up tariff, six criteria must be met, of which time-to-surgery within 36 hours is one. Our department currently recommends withholding NOAC medication and delaying surgery for at least 48 hours as per our Trust's haematology guidelines to reduce intra-operative bleeding risk. Therefore, the conditional top-up tariff cannot be claimed for these patients.

Method

A retrospective review of our Trust hip fracture patients over 60 years of age admitted during 2019 on NOAC medication using National Hip Fracture Database (NHFD).