Background

Hip fracture in elderly patients is associated with a significant mortality which may be worsened by COVID-19 infection.

Objective

To undertake a systematic review and meta-analysis of studies assessing the effect of COVID-19 infection and mortality rates in hip fracture patients in the United Kingdom (UK) during the first surge of the pandemic.

Design

A systematic literature search of 9 online databases was undertaken independently by 2 reviewers using the Cochrane methodology for systematic reviews. Eligibility criteria were any study of an adult population with a hip fracture that assessed the relationship between COVID-19 infection and 30-day mortality in the UK. Meta-analysis was conducted using a random-effects model.

Results

Out of 309 identified articles, 10 studies reporting on 2448 hip fracture patients met the inclusion criteria. Meta-analysis showed that the estimated mortality rate in patients with laboratory confirmed COVID-19 infection was 32.5% (95% CI= 28.3 to 37.0) compared to 8.6% (95% CI= 6.3 to 11.6) in COVID-19 negative patients. Meta-analysis of 9 comparative studies showed a significantly higher mortality in patients with laboratory confirmed COVID-19 infection as compared to patients without (RR=3.937, 95% CI= 2.867 to 5.406, P<.001). Similar findings were obtained when comparing mortality in COVID-19 laboratory confirmed or clinically suspected infected vs non-infected patients (RR=4.576, 95% CI = 3.589 to 5.835, P <.001).

Conclusions

COVID-19 infection is associated with a 4-fold increase in mortality risk in hip fracture patients. Every effort should be made to avoid COVID-19 infection and nosocomial exposure in this highly vulnerable patient group.

中文翻译：

---

COVID-19 与英国髋部骨折患者 30 天死亡率增加 4 倍有关：系统评价和荟萃分析

背景

老年患者的髋部骨折与死亡率显着相关，而 COVID-19 感染可能会加剧这种情况。

客观的

对评估 COVID-19 感染和死亡率在大流行第一次激增期间英国 (UK) 髋部骨折患者的影响的研究进行系统回顾和荟萃分析。

设计

2 名评审员使用 Cochrane 系统评价方法独立地对 9 个在线数据库进行了系统文献检索。资格标准是对髋部骨折成年人群的任何研究，该研究评估了英国 COVID-19 感染与 30 天死亡率之间的关系。使用随机效应模型进行荟萃分析。

结果

在 309 篇已确定的文章中，有 10 项研究报告了 2448 名髋部骨折患者，符合纳入标准。荟萃分析显示，实验室确诊的 COVID-19 感染患者的估计死亡率为 32.5%（95% CI = 28.3 至 37.0），而 COVID-19 阴性患者的死亡率为 8.6%（95% CI = 6.3 至 11.6）。对 9 项比较研究的荟萃分析显示，与未感染 COVID-19 的患者相比，实验室确诊的 COVID-19 患者的死亡率显着升高（RR=3.937，95% CI=2.867 至 5.406，P<.001）。在比较 COVID-19 实验室确诊或临床疑似感染与未感染患者的死亡率时，也获得了类似的结果（RR=4.576, 95% CI = 3.589 to 5.835, P <.001）。

结论

COVID-19 感染与髋部骨折患者死亡风险增加 4 倍有关。应尽一切努力避免在这一高度脆弱的患者群体中感染 COVID-19 和院内暴露。