Abstract
IntroductionCOVID-19 has been recognized as the unprecedented global health crisis in modern times. The purpose of this study was to assess the impact of COVID-19 on treatment of neck of femur fractures (NOFF) against the current guidelines and meeting best practice key performance indicators (KPIs) according to the National Hip Fracture Database (NHFD) in two large central London hospitals.Materials and methodsA multi-center, longitudinal, retrospective, observational study of NOFF patients was performed for the first ‘golden’ month following the lockdown measures introduced in mid-March 2020. This was compared to the same time period in 2019.ResultsA total of 78 cases were observed. NOFFs accounted for 11% more of all acute referrals during the COVID era. There were fewer overall breaches in KPIs in time to theatre in 2020 and also for those awaiting an orthogeriatric review. Time to discharge from the trust during the pandemic was improved by 54% (p < 0.00001) but patients were 51% less likely to return to their usual residence (p = 0.007). The odds ratio was significantly higher for consultant surgeon-led operations and consultant orthogeriatric-led review in the post-COVID era. There was no significant difference in using aerosol-generating anaesthetic procedures or immortality rates between both years.ConclusionThe impact of COVID-19 pandemic has not adversely affected the KPIs for the treatment of NOFF patients with significant improvement in numerous care domains. These findings may represent the efforts to ensure that these vulnerable patients are treated promptly to minimize their risks from the coronavirus.
Highlights
Introduction COVID19 has been recognized as the unprecedented global health crisis in modern times
This study represents a multi-centered experience of COVID-19 on the treatment of neck of femur fractures (NOFF)
The prevalence and demographics of NOFF remained unchanged during the COVID-19 period
Summary
Introduction COVID19 has been recognized as the unprecedented global health crisis in modern times. Chelsea & Westminster NHS Foundation Trust, London, UK. This vulnerable group has been urged to take more stringent precautions compared to the general population and to stay at home from mid-March for at least 3 months [2, 3]. Despite this advice, neck of femur fractures (NOFFs) continue to occur in the vulnerable demographic as the majority tend to occur within their home environment (despite the reduction in the NOFFs occurring outdoors). The prevalence is unlikely to be significantly affected by the social distancing measures imposed unlike other injuries that saw a reduction during the pandemic [4,5,6].
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