The Impact of COVID-19 on the Prevalence, Mortality, and Associated Risk Factors for Mortality in Patients with Hip Fractures: A Meta-Analysis.
Lifeng Ding, Jingzan Wei, Bin Wang
PMID 37062371WHAT IT FOUND
Patients with hip fractures who had COVID-19 died within 30 days at a rate of 24.29%, compared with 6.44% for those without the infection.
The risk of death was 3.97 times higher for the infected group.
Key findings
01The 30-day mortality rate for patients with hip fracture and COVID-19 was 24.29%, versus 6.44% for those without the infection, representing a risk ratio of 3.97.
02The pooled prevalence of COVID-19 among patients with hip fractures was 21%.
03Risk factors for 30-day mortality included COVID-19 infection, male gender, age over 75, ASA grade II-V, dementia, malignancy, medical comorbidities, renal disease, and pulmonary disease.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
There was significant heterogeneity among the included studies, likely due to differences in how COVID-19 was diagnosed (some used symptoms and CT scans without lab confirmation, others used PCR tests). Fourteen of the 60 included studies were rated as poor quality or high risk of bias. The analysis could not distinguish whether patients entered the hospital with COVID-19 or acquired it during their stay, which may influence outcomes. Data on specific surgical factors like type of anesthesia and anticoagulant use were not consistently reported, so their impact on mortality could not be analyzed.
The easy way to misread this
Do not assume that the higher mortality is caused solely by the virus. The study is observational, so the association between COVID-19 and death may be influenced by confounding factors such as the severity of the initial fracture, the patients' existing health conditions, or the strain on hospital resources during the pandemic.