Impact of the COVID-19 Pandemic on Clinical Outcomes after Hip Fracture Surgery in Elderly Patients.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic led to mandatory screening of hospitalized patients. This study aims to assess the impact of COVID-19 admission delays on clinical outcomes, specifically complications and mortality, in elderly patients following hip fracture surgery.

Materials and methods: This study included 563 patients (aged ≥70 years) who underwent hip fracture surgery between February 2018 to January 2021 and were followed up for at least one year. The cohort was divided into two groups: a pre-COVID-19 pandemic group (control group) and a COVID-19 pandemic group (study group). The patients who tested positive for COVID-19 were excluded. The demographic data, the time from injury to surgery, admission to surgery, postoperative complications, and 1-year mortality were collected and compared between the two groups.

Results: The time from injury to surgery was significantly longer in the study group compared to the control group, primarily due to delays in the time from injury to hospital visit and from hospital visit to admission (4.6 days vs. 3.7 days, P=0.026). However, there was no significant difference between the groups from admission to operation. The incidence of postoperative medical complications and one-year mortality rate were significantly higher in the study group (P=0.025 and P=0.034).

Conclusion: Our findings suggest that delays in the time from injury to hospital visit and hospital visit to admission during the COVID-19 pandemic led to significant delays in hip fracture surgery for elderly patients. These delays were associated with increased postoperative medical complications and a higher one-year mortality rate.