@article{ref1,
title="The impact of COVID-19 on morbidity and mortality in neck of femur fracture  patients: a prospective case-control cohort study",
journal="Bone and joint open",
year="2020",
author="Ward, Alex E. and Tadross, Daniel and Wells, Fiona and Majkowski, Lawrence and Naveed, Umna and Jeyapalan, Rathan and Partridge, David G. and Madan, Suvira and Blundell, Chris M.",
volume="1",
number="11",
pages="669-675",
abstract="AIMS: Within the UK, around 70,000 patients suffer neck of femur (NOF) fractures  annually. Patients presenting with this injury are often frail, leading to increased  morbidity and a 30-day mortality rate of 6.1%. COVID-19 infection has a broad  spectrum of clinical presentations with the elderly, and those with pre-existing  comorbidities are at a higher risk of severe respiratory compromise and death. Further increased risk has been observed in the postoperative period. The aim of  this study was to assess the impact of COVID-19 infection on the complication and  mortality rates of NOF fracture patients. <br><br>METHODS: All NOF fracture patients  presenting between March 2020 and May 2020 were included. Patients were divided into  two subgroup: those with or without clinical and/or laboratory diagnosis of  COVID-19. Data were collected on patient demographics, pattern of injury,  complications, length of stay, and mortality. <br><br>RESULTS: Overall, 132 patients were  included. Of these, 34.8% (n = 46) were diagnosed with COVID-19. Bacterial pneumonia  was observed at a significantly higher rate in those patients with COVID-19 (56.5%  vs 15.1%; p =< 0.000). Non respiratory complications such as acute kidney injury  (30.4% vs 9.3%; p =0.002) and urinary tract infection (10.9% vs 3.5%; p =0.126) were  also more common in those patients with COVID-19. Length of stay was increased by a  median of 21.5 days in patients diagnosed with COVID-19 (p < 0.000). 30-day  mortality was significantly higher in patients with COVID-19 (37.0%) when compared  to those without (10.5%; p <0.000). <br><br>CONCLUSION: This study has shown that patients  with a neck of femur fracture have a high rate of mortality and complications such  as bacterial pneumonia and acute kidney injury when diagnosed with COVID-19 within  the perioperative period. We have demonstrated the high risk of in hospital  transmission of COVID-19 and the association between the infection and an increased  length of stay for the patients affected.Cite this article: Bone Joint Open  2020;1-11:669-675.<p /> <p>Language: en</p>",
language="en",
issn="2633-1462",
doi="10.1302/2633-1462.111.BJO-2020-0141.R1",
url="http://dx.doi.org/10.1302/2633-1462.111.BJO-2020-0141.R1"
}