Hip fractures in Israel during the COVID-19 pandemic

Abstract

Efforts to contain the COVID-19 pandemic temporarily changed socializing behaviors as well as health care, including orthopedic trauma care. The Israeli National Program for Quality Indicators (NPQI) has been monitoring the incidence, timeliness, and outcomes of Hip Fracture (HF) surgical repair in all Israeli hospitals since 2013. The aim of this study is to examine the effect of the COVID-19 outbreak on HF incidence, treatment, and outcomes. An NPQI Quality Indicator requires surgical repair within 48 h of hospitalization. Records from 2018 through 2021 were compared. We found annual HF incidence relatively stable, with a drop in 2020. The median Length of Stay (LoS) was shorter in 2020 than in the pre-pandemic period, as was the median admission-to-surgery time. However, in 2021, the LoS and admission-to-surgery times rebounded towards pre-pandemic values. There was a noticeable decline in HF incidence during the two strict lockdown periods, followed immediately by short-term relative rises. 30-day mortality, median age, and gender distribution remained stable over the study period. In conclusion, the COVID-19 pandemic lockdown periods had a noticeable impact on HF incidence in Israel, with a decrease during lockdowns followed by a rebound effect. Additionally, the pandemic situation had an effect on the timing of surgical repairs, with shorter LoS and time to surgery. In 2021, there was a gradual return to pre-pandemic values. These findings point to a need for continued monitoring and adaptation of healthcare systems to respond to changing circumstances and ensure optimal care for patients with HF. The fact that HF incidence decreased during strict lockdowns and rebounded afterward points to a need to adapt public places to be safer for the elderly.