Characteristics and clinical outcomes of hip fracture patients during the first lockdown of COVID-19,lessons learnt: A retrospective cohort analysis

Abstract

Background

The management of hip fracture patients has been challenging across the UK in the wake of emergency coronavirus disease 2019 guidelines.

Aims

This retrospective, observational cohort study analyses the impact of the first lockdown during the early part of the coronavirus disease 2019 pandemic on the management of hip fracture patients at a district general hospital in the UK.

Methods

Comparative analysis to assess hip fracture patients treated at this Trust between 1 April to 31 May 2019 and 1 April to 31 May 2020 was undertaken. The primary outcome measures appraised were 30 and 60-day mortality and the secondary outcome measure included time to surgery.

Results

There was a higher 30 and 60-day mortality rate in the first lockdown period at 8.1% and 13.5%, respectively, compared to 1.96% and 5.88% in 2019. A significantly lower proportion of hip fracture patients at 59.46% were operated within the 36h target time frame during the first lockdown.

Conclusion

In our Trust, hip fractures were treated as obligatory injuries. However, the mortality was higher in the 2020 cohort with a significant reduction in patients achieving the recommended ‘36 hours’ time to surgery target and accruement of Best Practice Tariff. Enhanced infection control strategies have prepared us for the future.