A Study of Outcomes in Patients With Fractured Neck of Femur During the COVID-19 Pandemic

Barts & The London NHS Trust

Status: Completed

Conditions: SARS-CoV 2; Femoral Neck Fractures

Treatments: Other: Surgery: Dynamic Hip Screw, hemiarthroplasty, hip replacement, intramedullary nail

Study type: Observational

Funder types: Other

Identifiers

NCT04375501

284104

Details and patient eligibility

About

In early 2020 the evolving COVID-19 Pandemic provided the world and medical community with a generational challenge. As a novel disease, countries were left with strategic decisions and many went into social lockdown. Initial resources and research were directed at upscaling internal medicine and intensive care services, understanding the disease pathophysiology, and testing treatments. It soon became evident that COVID-19 had multi-system effects at it's worst. In orthopaedics one of the most vulnerable groups to COVID-19 were the elderly, specifically those who suffered fractured neck of femur at this time. More literature is needed urgently if we are to understand and mitigate the negative impacts in this group of patients. This observational study assesses the early morbidity and mortality of patients with this diagnosis during the evolving COVID-19 Pandemic.

Full description

Many elderly patients admitted to hospitals during the evolving COVID-19 pandemic after falls or being generally unwell, were considered to have a possible diagnosis of COVID-19. This was extremely relevant to the subgroup of patients who suffered from fractured neck of femurs during this time, with most of them elderly, frail, and more likely to have multiple co-morbidities. COVID-19 was considered a precipitating factor for falls, but also anecdotally, an indicator of potentially poor recovery and rehabilitation.

With regards to orthopaedic and trauma surgery, a limited amount of literature is available pertaining to COVID-19 and specifically it's potential effects on patient outcomes in patients requiring surgery.

We performed a multi centre observational study across London, United Kingdom, looking at the demographics and details of patients admitted with fractured neck of femur during the evolving pandemic. All data collected was non identifiable. Data was also collected as to the COVID-19 status of these patients, either positive or negative. Data was analysed to assess the morbidity and mortality of this patient group and search for any prognostic factors.

Enrollment: 442 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Fractured neck of femur
• Received operative intervention for fractured neck of femur

Exclusion criteria

• open fracture
• fracture of femoral shaft
• periprosthetic fracture
• revision surgery

Trial design

442 participants in 2 patient groups

COVID-19 positive

Description:

All patients admitted with fractured neck of femur during specified time period testing POSITIVE for COVID-19

Treatment:

Other: Surgery: Dynamic Hip Screw, hemiarthroplasty, hip replacement, intramedullary nail

COVID-19 negative

Description:

All patients admitted with fractured neck of femur during specified time period testing NEGATIVE for COVID-19

Treatment:

Other: Surgery: Dynamic Hip Screw, hemiarthroplasty, hip replacement, intramedullary nail