Summary

Fragility fractures (i.e., low-energy fractures) account for most fractures among older Canadians and are associated with significant increases in morbidity and mortality. Study results suggest that low-energy fracture rates (associated with surgical intervention and outcomes) declined slightly, but largely remained stable in the first few months of the COVID-19 pandemic.

Purpose/introduction

This study describes rates of low-energy fractures, time-to-surgery, complications, and deaths post-surgery in patients with fractures during the coronavirus disease (COVID-19) pandemic in Alberta, Canada, compared to the three years prior.

Methods

A repeated cross-sectional study was conducted using provincial-level administrative health data. Outcomes were assessed in 3-month periods in the 3 years preceding the COVID-19 pandemic and in the first two 3-month periods after restrictions were implemented. Patterns of fracture- and hospital-related outcomes over the control years (2017–2019) and COVID-19 restrictions periods (2020) were calculated.

Results

Relative to the average from the control periods, there was a slight decrease in the absolute number of low-energy fractures (n = 4733 versus n = 4308) during the first COVID-19 period, followed by a slight rise in the second COVID-19 period (n = 4520 versus n = 4831). While the absolute number of patients with low-energy fractures receiving surgery within the same episode of care decreased slightly during the COVID-19 periods, the proportion receiving surgery and the proportion receiving surgery within 24 h of admission remained stable. Across all periods, hip fractures accounted for the majority of patients with low-energy fractures receiving surgery (range: 58.9–64.2%). Patients with complications following surgery and in-hospital deaths following fracture repair decreased slightly during the COVID-19 periods.

Conclusions

These results suggest that low-energy fracture rates, associated surgeries, and surgical outcomes declined slightly, but largely remained stable in the first few months of the pandemic. Further investigation is warranted to explore patterns during subsequent COVID-19 waves when the healthcare system experienced severe strain.

中文翻译：

---

加拿大艾伯塔省 COVID-19 大流行期间骨质疏松性骨折和相关院内并发症的趋势

概括

脆性骨折（即低能量骨折）是加拿大老年人骨折的主要原因，并且与发病率和死亡率的显着增加有关。研究结果表明，低能量骨折率（与手术干预和结果相关）略有下降，但在 COVID-19 大流行的头几个月基本保持稳定。

目的/介绍

本研究描述了与三年前相比，加拿大阿尔伯塔省冠状病毒病 (COVID-19) 大流行期间骨折患者的低能量骨折发生率、手术时间、并发症和术后死亡率。

方法

使用省级行政卫生数据进行了重复的横断面研究。结果在 COVID-19 大流行前 3 年的 3 个月内以及实施限制后的前两个 3 个月内进行了评估。计算了对照年（2017-2019 年）和 COVID-19 限制期（2020 年）骨折和住院相关结果的模式。

结果

 相对于对照期的平均值，在第一个 COVID-19 期间，低能量骨折的绝对数量略有下降（n  = 4733 对n = 4308），随后在第二个 COVID-19 期间略有上升19 期（n  = 4520 对n = 4831）。虽然在 COVID-19 期间接受同一治疗的低能量骨折患者的绝对数量略有下降，但接受手术的比例和入院 24 小时内接受手术的比例保持稳定。在所有时期，髋部骨折占接受手术的低能量骨折患者的大多数（范围：58.9-64.2%）。在 COVID-19 期间，手术后并发症和骨折修复后住院死亡的患者略有减少。

结论

这些结果表明，低能量骨折率、相关手术和手术结果略有下降，但在大流行的头几个月基本保持稳定。当医疗保健系统经历严重压力时，有必要进一步调查以探索随后的 COVID-19 浪潮中的模式。