A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol
Introduction: Our aim was to analyse how the coronavirus disease 2019 (COVID-19) pandemic affects a hip fracture bundled care protocol. We hypothesised that key performance indicators, but not short-term outcomes, may be adversely affected. Methods: Patients admitted under a hip fracture bundled car...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2024-12-01
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| Series: | Singapore Medical Journal |
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| Online Access: | https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-351 |
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| _version_ | 1823863749906268160 |
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| author | Khai Cheong Wong Kenny Xian Khing Tay Suang Bee Koh Tet Sen Howe |
| author_facet | Khai Cheong Wong Kenny Xian Khing Tay Suang Bee Koh Tet Sen Howe |
| author_sort | Khai Cheong Wong |
| collection | DOAJ |
| description | Introduction:
Our aim was to analyse how the coronavirus disease 2019 (COVID-19) pandemic affects a hip fracture bundled care protocol. We hypothesised that key performance indicators, but not short-term outcomes, may be adversely affected.
Methods:
Patients admitted under a hip fracture bundled care protocol were divided into two arms: ‘COVID’ group included patients admitted in 2020 during the COVID-19 pandemic and ‘PRE-COVID’ group included patients admitted in 2019. We retrospectively analysed time to admission, time to surgery, length of stay, discharge disposition, as well as rates of 30-day revision surgery, 30-day readmission and inpatient mortality.
Results:
There were 307 patients in the PRE-COVID group and 350 patients in the COVID group. There was no significant difference in terms of gender, age and type of hip fracture. The COVID group had a higher proportion of American Society of Anesthesiologists classification III and IV patients (61.4% vs. 50.2% in the PRE-COVID group; P = 0.004). In the COVID group, similar proportion of patients were admitted to the ward within 4 h, but the mean time to surgery was longer (71.8 ± 73.0 h vs. 60.4 ± 72.8 h in the PRE-COVID group; P = 0.046) and few patients underwent operations within 48 h (41.7% vs. 60.3% in the PRE-COVID group; P < 0.001). Mean postoperative length of stay, discharge disposition, as well as rates of inpatient mortality, 30-day revision surgery and 30-day readmission were similar.
Conclusion:
The volume of hip fractures during the COVID-19 pandemic remained unchanged, although patients admitted during the COVID-19 pandemic appeared to be more deconditioned. Nevertheless, having robust protocols and staff familiar with hip fracture treatment can preserve short-term outcomes for this group of patients, even with strict isolation measures in place during a pandemic. |
| format | Article |
| id | doaj-art-314e0fd8658447c4bc3ecc88c386a288 |
| institution | Kabale University |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-314e0fd8658447c4bc3ecc88c386a2882025-02-09T10:28:25ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352024-12-01651266967310.4103/singaporemedj.SMJ-2021-351A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocolKhai Cheong WongKenny Xian Khing TaySuang Bee KohTet Sen HoweIntroduction: Our aim was to analyse how the coronavirus disease 2019 (COVID-19) pandemic affects a hip fracture bundled care protocol. We hypothesised that key performance indicators, but not short-term outcomes, may be adversely affected. Methods: Patients admitted under a hip fracture bundled care protocol were divided into two arms: ‘COVID’ group included patients admitted in 2020 during the COVID-19 pandemic and ‘PRE-COVID’ group included patients admitted in 2019. We retrospectively analysed time to admission, time to surgery, length of stay, discharge disposition, as well as rates of 30-day revision surgery, 30-day readmission and inpatient mortality. Results: There were 307 patients in the PRE-COVID group and 350 patients in the COVID group. There was no significant difference in terms of gender, age and type of hip fracture. The COVID group had a higher proportion of American Society of Anesthesiologists classification III and IV patients (61.4% vs. 50.2% in the PRE-COVID group; P = 0.004). In the COVID group, similar proportion of patients were admitted to the ward within 4 h, but the mean time to surgery was longer (71.8 ± 73.0 h vs. 60.4 ± 72.8 h in the PRE-COVID group; P = 0.046) and few patients underwent operations within 48 h (41.7% vs. 60.3% in the PRE-COVID group; P < 0.001). Mean postoperative length of stay, discharge disposition, as well as rates of inpatient mortality, 30-day revision surgery and 30-day readmission were similar. Conclusion: The volume of hip fractures during the COVID-19 pandemic remained unchanged, although patients admitted during the COVID-19 pandemic appeared to be more deconditioned. Nevertheless, having robust protocols and staff familiar with hip fracture treatment can preserve short-term outcomes for this group of patients, even with strict isolation measures in place during a pandemic.https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-351bundled carecovid-19hip fracturepatient outcomes |
| spellingShingle | Khai Cheong Wong Kenny Xian Khing Tay Suang Bee Koh Tet Sen Howe A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol Singapore Medical Journal bundled care covid-19 hip fracture patient outcomes |
| title | A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol |
| title_full | A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol |
| title_fullStr | A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol |
| title_full_unstemmed | A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol |
| title_short | A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol |
| title_sort | year of covid 19 effects of a global pandemic on a hip fracture bundled care protocol |
| topic | bundled care covid-19 hip fracture patient outcomes |
| url | https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-351 |
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