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Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case–Control Study from a Single Center in Italy

Author

Listed:
  • Alberto Grassi

    (II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

  • Luca Andriolo

    (II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

  • Davide Golinelli

    (Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy)

  • Dario Tedesco

    (IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

  • Simona Rosa

    (Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy)

  • Pasquale Gramegna

    (Medicina e Reumatologia, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

  • Jacopo Ciaffi

    (Medicina e Reumatologia, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

  • Riccardo Meliconi

    (Medicina e Reumatologia, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

  • Maria Paola Landini

    (IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

  • Giuseppe Filardo

    (Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy)

  • Maria Pia Fantini

    (Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy)

  • Stefano Zaffagnini

    (II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy)

Abstract

The mortality of hip fracture (HF) patients is increased by concomitant COVID-19; however, evidence is limited to only short follow-up. A retrospective matched case–control study was designed with the aim to report the 90-day mortality and determine the hazard ratio (HR) of concomitant HF and COVID-19 infection. Cases were patients hospitalized for HF and diagnosed with COVID-19. Controls were patients hospitalized for HF not meeting the criteria for COVID-19 diagnosis and were individually matched with each case through a case–control (1:3) matching algorithm. A total of 89 HF patients were treated during the study period, and 14 of them were diagnosed as COVID-19 positive (overall 15.7%). Patients’ demographic, clinical, and surgical characteristics were similar between case and control groups. At 90 days after surgery, 5 deaths were registered among the 14 COVID-19 cases (35.7%) and 4 among the 42 HF controls (9.5%). COVID-19-positive cases had a higher risk of mortality at 30 days (HR = 4.51; p = 0.0490) and 90 days (HR = 4.50; p = 0.025) with respect to controls. Patients with concomitant HF and COVID-19 exhibit high perioperative mortality, which reaches a plateau of nearly 30–35% after 30 to 45 days and is stable up to 90 days. The mortality risk is more than four-fold higher in patients with COVID-19.

Suggested Citation

  • Alberto Grassi & Luca Andriolo & Davide Golinelli & Dario Tedesco & Simona Rosa & Pasquale Gramegna & Jacopo Ciaffi & Riccardo Meliconi & Maria Paola Landini & Giuseppe Filardo & Maria Pia Fantini & S, 2021. "Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case–Control Study from a Single Center in Italy," IJERPH, MDPI, vol. 18(10), pages 1-13, May.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:10:p:5205-:d:554264
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    References listed on IDEAS

    as
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