摘要
BACKGROUND Timely intervention in hip fracture is essential to decrease the risks of perioperative morbidity and mortality.However,limitations of the resources,risk of disease transmission and redirection of medical attention to a more severe infective health problem during coronavirus disease 2019(COVID-19)pandemic period have affected the quality of care even in a surgical emergency.AIM To compare the 30-d mortality rate and complications of hip fracture patients treated during COVID-19 pandemic and pre-pandemic times.METHODS The search of electronic databases on 1st August 2020 revealed 45 studies related to mortality of hip fracture during the COVID-19 pandemic and pre-pandemic times.After careful screening,eight studies were eligible for quantitative and qualitative analysis of data.RESULTS The pooled data of eight studies(n=1586)revealed no significant difference in 30-d mortality rate between the hip fracture patients treated during the pandemic and pre-pandemic periods[9.63%vs 6.33%;odds ratio(OR),0.62;95%CI,0.33,1.17;P=0.14].Even the 30-d mortality rate was not different between COVID-19 non-infected patients who were treated during the pandemic time,and all hip fracture patients treated during the pre-pandemic period(OR,1.03;95%CI,0.61,1.75;P=0.91).A significant difference in mortality rate was observed between COVID-19 positive and COVID-19 negative patients(OR,6.99;95%CI,3.45,14.16;P<0.00001).There was no difference in the duration of hospital stay(OR,-1.52,95%CI,-3.85,0.81;P=0.20),overall complications(OR,1.62;P=0.15)and incidence of pulmonary complications(OR,1.46;P=0.38)in these two-time frames.Nevertheless,the preoperative morbidity was more severe,and there was less use of general anesthesia during the pandemic time.CONCLUSION There was no difference in 30-d mortality rate between hip fracture patients treated during the pandemic and pre-pandemic periods.However,the mortality risk was higher in COVID-19 positive patients compared to COVID-19 negative patients.There was no difference in time to surgery,complications and hospitalization time between these two time periods.
