P46 Effect of the COVID-19 pandemic on hip fracture patients in a Teaching London Hospital

Abstract

IntroductionHip fractures are the commonest serious injury in older people, the commonest reason for older people needing surgery and the commonest cause of death following an accident. The NHFD is a national database whereby markers of care are recorded prospectively for patients over 60 years sustaining a hip fracture and requiring inpatient care, with a Best Practice Tariff linked to key performance indicators. The aim of this study was to review how care varied for patients sustaining a hip fracture during the COVID-19 pandemic compared to the equivalent time last year.MethodsUsing the NHFD we compared data from March – May 2019 to the same period in 2020 during the pandemic at St George’s Hospital. The study provides a snapshot of care during the pandemic.ResultsThere were more admissions and more discharges during the pandemic. There was an increase in time to theatre and subsequent reduction in BPT. There was also an increase in non- operative treatment for these patients. 6 patients were confirmed COVID-19 positive, one of whom died. There was a reduction in time to ortho-geriatrician review and also a reduction in delirium review post-operatively. Length of stay was also reduced.ConclusionThe COVID-19 pandemic had an effect on care provided to hip fracture patients. There was an increase in time and a deterioration in orthogeriatric review within 72 hours. The length of stay however improved due to improved focus on pathways and discharge processes. There was also a lower threshold to offer non- operative care wherever possible.