Abstract:

Objective Our objective was to evaluate the mid-to-long term mortality rates (with an average of 1-year follow-up) and associated factors of geriatric patients with hip fractures during the COVID-19 pandemic. Methods Prospectively followed-up 104 geriatric patients over 65 years old, with hip fractures during the pandemic, 89 of which underwent surgery, were evaluated. A control group of 126 geriatric patients treated for hip fractures before the pandemic was formed. Patient demographics, initial SARS-Cov-2 Reverse Transcriptase PCR test results, fracture type, type of surgery performed, length of stay (LOS) in hospital early complications were analyzed. Results Mid-to-long term mortality rate of geriatric patients with hip fractures treated during the pandemic period was 42.3% whereas the mortality rate of control group was calculated as 38.9% (p=0.599). Patients that were unfit for surgery and patients with positive initial SARS-Cov-2 Reverse Transcriptase PCR test were significantly related with higher mortality (p<0.001 for each). Among the geriatric patients with operated hip fractures, presence of early complications, longer LOS in intensive care units postoperatively and longer total LOS in hospital were significantly related with higher mortality (p=0.017, p=0.001 and p=0.045 respectively). Conclusion Patients with a positive initial SARS-Cov-2 Reverse Transcriptase PCR test and deemed as unfit for surgery have higher mortality rates. On the other hand, with correct management and separation of COVID and non-COVID patients and medical staff, increased mortality may be avoidable among patients treated surgically. Alas, it may not always be possible to avoid some of the related factors of increased mortality.

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