338 Profile of older adults post hip fracture: a pre and post-Covid comparison

Abstract

Abstract Background The Irish Government implemented public health measures during the COVID-19 pandemic, including self-isolation among older citizens. Within our rehabilitation centre, the multidisciplinary team remarked on what they perceived to be negative health repercussions from ‘cocooning’, particularly those admitted following hip fracture. We sought to compare patient cohorts in 2019 and 2022. Methods Data was examined from the Irish Hip Fracture Database online portal specific to our Model 3 hospital for 2019 and 2022. Subset analysis was performed on hip fracture patients admitted to an off-site rehabilitation centre using that hospital’s electronic patient database. Results 245 hip fractures were recorded in 2019 and 380 in 2022. In 2019 37% were aged between 80–89, 12% were over 90. In 2022 45% were aged between 80–89, 14% were over 90. ASA grade pre-operatively; in 2019, 33% were classed as normal or with mild systemic disease, 61% were in the severe systemic disease category. The same categories in 2022 were 41% and 55% respectively. Discharge destination for patients in 2019 and 2022 respectively were as follows: discharged directly home 27% vs 25%, discharged to offsite rehabilitation 32% vs. 38%, new Long-Term Care (LTC) admission 2% vs 3%. Our rehabilitation unit received 26 patients in 2019 and 39 in 2022. The average timed up and go (TUG) on admission in 2019 vs 2022 was 38.7 and 53.7 seconds respectively. Conclusion There was a 55% increase in the number of patients presenting with hip fracture post Covid. Despite similar age and co-morbidity profiles patients average TUG was 39% slower post Covid. Less patients were discharged directly home in 2022, more patients required a period of rehabilitation and the number of new admissions to LTC increased. This small study supports our hypothesis surrounding the detrimental effects of cocooning on older patients.