COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels?
Publication in refereed journal

替代計量分析
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其它資訊
摘要Introduction
The COVID-19 pandemic has caused high mortality rates in hip fracture patients, but data for Asian patients are lacking. Whilst Cycle threshold (Ct) values and D-dimer have been reported as predictors of mortality in COVID-19 patients, their prognostic roles in those with concomitant hip fracture remain unknown. The objectives of this study were to i) assess the clinical outcomes of COVID-19 hip fractures patients in the Chinese population, ii) identify risk factors of mortality and complications, and iii) determine the prognostic roles of Ct values and D-dimer levels.

Methodology
This cohort study was conducted during the 5th wave of the COVID-19 pandemic. Inclusion criteria were 1) hip fracture 2) ​≥ ​60 years old 3) low-energy trauma. Outcomes were 90-day all-cause mortality, complications, length of stay, discharge destination and mobility status. Logistic regression analysis was performed to identify risk factors for mortality and complications. Subgroup analysis was performed for patients with Ct ​< ​30 and Ct ​> ​30, comparing their outcomes of operations performed within 48 ​h vs beyond 48 ​h.

Results
159 hip fracture patients were included, 42 patients were COVID-19 positive. COVID-19 group had significantly higher 90-day mortality rates (21.4% vs 9.4%), complication rates (45.2% vs 28.2%) and longer length of stay (17.06 vs 10.84 nights). COVID-19 was an independent risk factor for mortality and complications. Amongst the COVID-19 group, risk factors for poor outcomes were advanced age, steroids use, conservative treatment and American Society of Anaesthesiologists (ASA) score ≥ 3. Conservative treatment was associated with higher mortality (OR ​= ​16.00; p ​= ​0.025) in COVID-19 hip fracture patients. There was no significant difference between Ct values ​< ​30 and >30 regarding mortality and complication rate. D-dimer and timing to operation did not affect outcomes.

Conclusions
Patients with concomitant COVID-19 and hip fracture are at high risk of mortality and complications. Ct values and D-dimer levels have no prognostic roles for hip fracture outcomes. Early operative treatment is recommended as soon as patients are medically fit.
著者Kwan Hung Moya Tsui, Wai Wang Chau, Wing Hong Liu, Cheuk Yin Tam, Dennis King Hang Yee, Chi Yin Tso, Ning Zhang, Wing-Hoi Cheung, Ning Tang, Ronald Man Yeung Wong
期刊名稱Journal of Orthopaedic Translation
出版年份2023
月份11
卷號43
出版社Elsevier
頁次14 - 20
國際標準期刊號2214-031X
語言美式英語
關鍵詞COVID-19, Ct value, D-dimer, Hip fracture, Mortality

上次更新時間 2024-11-01 於 15:42