Hip & pelvis

The Korean Hip Society (대한고관절학회)
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The Effects of COVID-19 Pandemic on the Recovery of Hip Fracture Patients

  • Young Yool Chung (Department of Orthopedic Surgery, Kwangju Christian Hospital) ;
  • Sung Nyun Baek (Department of Orthopedic Surgery, Kwangju Christian Hospital) ;
  • Tae Gyu Park (Department of Orthopedic Surgery, Kwangju Christian Hospital) ;
  • Min Young Kim (Department of Orthopedic Surgery, Kwangju Christian Hospital)
  • Received : 2023.06.12
  • Accepted : 2023.09.13
  • Published : 2023.12.31
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Abstract

Purpose: To figure out how complete control of family visits to prevent infection of coronavirus disease 2019 (COVID-19) affected the activity recovery of hip fracture patients admitted to nursing hospitals. Materials and Methods: Eighty-one patients with hip surgery in the two years prior to COVID-19 pandemic were classified as Group A, and 103 patients in the next two years were designated as Group B. The subjects' walking ability was evaluated by using the modified Koval index (MKI). In order to analyze the impact of the family visit control to the subjects, each group was classified into two different groups: (1) inpatients group who admitted to nursing hospitals and (2) home-treated patients. Additionally, statistical elements were processed in consideration of other factors that may affect the results of the experiment. Results: The MKI evaluated at 6 months postoperative was 3.31±1.79 in Group A and 2.77±1.91 in Group B, and it was meaningfully low after the pandemic (P=0.04). There was significantly low among both of Group A 2.74±1.76 and Group B 1.93±1.81 after the pandemic (P=0.03) among those treated at the nursing hospital. The rate of deterioration of the MKI was 35 (43.2%) in Group A and 57 (55.3%) in Group B, which increased by 12.1% after the pandemic. Conclusion: The pandemic had a negative effect on the recovery of postoperative activities of elderly hip fracture patients who admitted to nursing hospitals when family access was completely restricted to prevent infection.

Keywords

References

  1. Kim BS, Lim JY, Ha YC. Recent epidemiology of hip fractures in South Korea. Hip Pelvis. 2020;32:119-24. https://doi.org/10.5371/hp.2020.32.3.119 
  2. Hong S, Han K. The incidence of hip fracture and mortality rate after hip fracture in Korea: a nationwide population-based cohort study. Osteoporos Sarcopenia. 2019;5:38-43. https://doi.org/10.1016/j.afos.2019.06.003 Erratum in: Osteoporos Sarcopenia. 2019;5:102. https://doi.org/10.1016/j.afos.2019.08.002 
  3. Oldmeadow LB, Edwards ER, Kimmel LA, Kipen E, Robertson VJ, Bailey MJ. No rest for the wounded: early ambulation after hip surgery accelerates recovery. ANZ J Surg. 2006;76:607-11. https://doi.org/10.1111/j.1445-2197.2006.03786.x 
  4. Okamoto T, Ridley RJ, Edmondston SJ, Visser M, Headford J, Yates PJ. Day-of-surgery mobilization reduces the length of stay after elective hip arthroplasty. J Arthroplasty. 2016;31:2227-30. https://doi.org/10.1016/j.arth.2016.03.066 
  5. Oberfeld J, von Hertzberg-Boelch SP, Weissenberger M, Holzapfel BM, Rudert M, Jakuscheit A. Effect of mobilization on the day of surgery after total hip arthroplasty in elderly, obese, and severely diseased patients. J Arthroplasty. 2021;36:3686-91. https://doi.org/10.1016/j.arth.2021.06.024 
  6. Pfeufer D, Kammerlander C, Stadler C, et al. Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients. Eur J Med Res. 2020;25:31. https://doi.org/10.1186/s40001-020-00433-2 
  7. Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD. Ambulatory ability after hip fracture. A prospective study in geriatric patients. Clin Orthop Relat Res. 1995;(310):150-9. 
  8. Kang SJ, Jung SI. Age-related morbidity and mortality among patients with COVID-19. Infect Chemother. 2020;52:154-64. https://doi.org/10.3947/ic.2020.52.2.154 
  9. Egol KA, Konda SR, Bird ML, et al. Increased mortality and major complications in hip fracture care during the COVID19 pandemic: a New York City perspective. J Orthop Trauma. 2020;34:395-402. https://doi.org/10.1097/BOT.0000000000001845 
  10. Slullitel PA, Lucero CM, Soruco ML, et al. Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology. Int Orthop. 2020;44:1887-95. https://doi.org/10.1007/s00264-020-04769-6 
  11. Zamora T, Sandoval F, Demandes H, et al. Hip fractures in the elderly during the COVID-19 pandemic: a Latin-American perspective with a minimum 90-day follow-up. Geriatr Orthop Surg Rehabil. 2021;12:21514593211024509. https://doi.org/10.1177/21514593211024509 
  12. Zhong H, Poeran J, Liu J, Wilson LA, Memtsoudis SG. Hip fracture characteristics and outcomes during COVID-19: a large retrospective national database review. Br J Anaesth. 2021;127:15-22. https://doi.org/10.1016/j.bja.2021.04.003 
  13. Wignall A, Giannoudis V, De C, et al. The impact of COVID19 on the management and outcomes of patients with proximal femoral fractures: a multi-centre study of 580 patients. J Orthop Surg Res. 2021;16:155. https://doi.org/10.1186/s13018-021-02301-z 
  14. Liu G, Yang M, Li N, Li S, Zhu S, Wu X. The effects of COVID19 on geriatric hip fracture management and 1-year mortality in Beijing. Orthop Surg. 2022;14:2527-34. https://doi.org/10.1111/os.13464 
  15. Simunovic N, Devereaux PJ, Sprague S, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ. 2010;182:1609-16. https://doi.org/10.1503/cmaj.092220 
  16. Malik-Tabassum K, Robertson A, Tadros BJ, et al. The effect of the COVID-19 lockdown on the epidemiology of hip fractures in the elderly: a multicentre cohort study. Ann R Coll Surg Engl. 2021;103:337-44. https://doi.org/10.1308/rcsann.2020.7071 
  17. Munin MC, Begley A, Skidmore ER, Lenze EJ. Influence of rehabilitation site on hip fracture recovery in community-dwelling subjects at 6-month follow-up. Arch Phys Med Rehabil. 2006;87:1004-6. https://doi.org/10.1016/j.apmr.2006.04.002 
  18. Patel JN, Klein DS, Sreekumar S, Liporace FA, Yoon RS. Outcomes in multidisciplinary team-based approach in geriatric hip fracture care: a systematic review. J Am Acad Orthop Surg. 2020;28:128-33. https://doi.org/10.5435/JAAOS-D-18-00425 
  19. Ariza-Vega P, Prieto-Moreno R, Castillo-Perez H, MartinezRuiz V, Romero-Ayuso D, Ashe MC. Family caregivers' experiences with tele-rehabilitation for older adults with hip fracture. J Clin Med. 2021;10:5850. https://doi.org/10.3390/jcm10245850 
  20. Karlsson A, Lindelof N, Olofsson B, et al. Effects of geriatric interdisciplinary home rehabilitation on independence in activities of daily living in older people with hip fracture: a randomized controlled trial. Arch Phys Med Rehabil. 2020;101:571-8. https://doi.org/10.1016/j.apmr.2019.12.007 
  21. Wu D, Zhu X, Zhang S. Effect of home-based rehabilitation for hip fracture: a meta-analysis of randomized controlled trials. J Rehabil Med. 2018;50:481-6. https://doi.org/10.2340/16501977-2328 
  22. Chung JW, Ha YC, Lee MK, Kim JH, Park JW, Koo KH. Hip fracture management during the COVID-19 pandemic in South Korea. Clin Orthop Surg. 2021;13:474-81. https://doi.org/10.4055/cios21123 
  23. Anusitviwat C, Vanitcharoenkul E, Chotiyarnwong P, Unnanuntana A. Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period. Osteoporos Int. 2022;33:2217-26. https://doi.org/10.1007/s00198-022-06485-w