The mortality of hip fracture (HF) patients is increased by concomitant COVID-19; however, evidence is limited to only short follow-up. A retrospective matched case–control study was designed with the aim to report the 90-day mortality and determine the hazard ratio (HR) of concomitant HF and COVID-19 infection. Cases were patients hospitalized for HF and diagnosed with COVID-19. Controls were patients hospitalized for HF not meeting the criteria for COVID-19 diagnosis and were individually matched with each case through a case–control (1:3) matching algorithm. A total of 89 HF patients were treated during the study period, and 14 of them were diagnosed as COVID-19 positive (overall 15.7%). Patients’ demographic, clinical, and surgical characteristics were similar between case and control groups. At 90 days after surgery, 5 deaths were registered among the 14 COVID-19 cases (35.7%) and 4 among the 42 HF controls (9.5%). COVID-19-positive cases had a higher risk of mortality at 30 days (HR = 4.51; p = 0.0490) and 90 days (HR = 4.50; p = 0.025) with respect to controls. Patients with concomitant HF and COVID-19 exhibit high perioperative mortality, which reaches a plateau of nearly 30–35% after 30 to 45 days and is stable up to 90 days. The mortality risk is more than four-fold higher in patients with COVID-19.

中文翻译：

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COVID-19 患者髋部骨折手术后 90 天死亡率较高：意大利单一中心的病例对照研究


合并感染 COVID-19 会增加髋部骨折 (HF) 患者的死亡率；然而，证据仅限于短期随访。设计了一项回顾性匹配病例对照研究，旨在报告 90 天死亡率并确定心力衰竭和 COVID-19 合并感染的风险比 (HR)。病例是因心力衰竭住院并被诊断患有 COVID-19 的患者。对照是因心力衰竭住院但不符合 COVID-19 诊断标准的患者，并通过病例对照 (1:3) 匹配算法与每个病例进行单独匹配。研究期间共有 89 名心力衰竭患者接受治疗，其中 14 人被诊断为 COVID-19 阳性（总体占 15.7%）。病例组和对照组之间患者的人口统计学、临床和手术特征相似。术后 90 天，14 例 COVID-19 病例中有 5 例死亡（35.7%），42 例心力衰竭对照者中有 4 例死亡（9.5%）。与对照组相比，COVID-19 阳性病例在 30 天（HR = 4.51； p = 0.0490）和 90 天（HR = 4.50； p = 0.025）时的死亡风险较高。合并心力衰竭和 COVID-19 的患者表现出较高的围手术期死亡率，30 至 45 天后达到近 30-35% 的稳定水平，并稳定长达 90 天。 COVID-19 患者的死亡风险高出四倍多。