Proximal femoral fractures in patients with COVID-19 : Pneumonia and admission from anursing home are the strongest predictors of mortality.

Abstract

Proximal femoral fractures are severe injuries in geriatric patients. Additionally, geriatric patients are at ahigh risk of death due to coronavirus disease 2019 (COVID-19). To identify predictors of mortality in geriatric patients with COVID-19 and concurrent proximal femoral fractures. Patients who underwent surgical treatment for proximal femoral fractures and also tested positive for COVID-19 were included. The age, gender, the American Society of Anesthesiology (ASA) score and the admission from anursing home were considered as variables. The rate of reoperations, the mortality at 3 months and discharge home were evaluated as outcomes. In this study 46 patients with COVID-19 (female/male 31/15, median age87.0 years with an interquartile range [IQR] of 9.8 years) met the inclusion criteria. Of these, 32patients (69.6%) had to be cared for in the intensive care unit and 26 patients (56.5%) had asevere course of COVID-19 with pneumonia. The median length of hospital stay for survivors was 19 (IQR 17.5) days and 4 of the patients (8.7%) required surgical revision. The in-hospital and 3‑month mortality were 40.0% (n = 17) and 43.5% (n = 20), respectively. The factors which influenced the in-hospital and 3‑month mortality rates were admission from anursing home, the presence of pneumonia (increased the risk of death) and female gender (protective). The occurrence of COVID-19 in patients with proximal femoral fractures has ahigh mortality. Admission from anursing home and the presence of pneumonia increased the risk of death, whereas women were at lower risk.