Evidence map›Paper›PMID 34401931›Full record

ArticleInternational orthopaedics2021

Should we operate on all patients with COVID-19 and proximal femoral fractures? An analysis of thirty, sixty, and ninety day mortality rates based on patients' clinical presentation and comorbidity: a multicentric study in Northern Italy.

Federico Fusini, Alessandro Massè, Salvatore Risitano, Andrea Ferrera, Emilio Enrietti, Kristijan Zoccola, Giuseppe Bianco, Fabio Zanchini, Gabriele Colò

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International orthopaedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Federico FusiniDepartment of Orthopaedic and Traumatology, Regina Montis Regalis Hospital, ASL CN1, Strada S Rocchetto 99, 12084, Mondovì, Italy. fusinif@hotmail.com.ORCID 0000-0002-4223-8485
Alessandro MassèDepartment of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città Della Salute E Della Scienza Di Torino, via Zuretti 29, 10126, Turin, Italy.
Salvatore RisitanoDepartment of Orthopaedic and Traumatology, Maggiore Hospital of Chieri, ASL TO5, via De Maria 1, 10023, Chieri, Italy.
Andrea FerreraDepartment of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città Della Salute E Della Scienza Di Torino, via Zuretti 29, 10126, Turin, Italy.
Emilio EnriettiDepartment of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città Della Salute E Della Scienza Di Torino, via Zuretti 29, 10126, Turin, Italy.
Kristijan ZoccolaDepartment of Orthopaedics and Traumatology, Regional Center for Joint Arthroplasty, ASO Alessandria, Via Venezia 16, 16121, Alessandria, Italy.
Giuseppe BiancoDepartment of Orthopaedic and Traumatology, Regina Montis Regalis Hospital, ASL CN1, Strada S Rocchetto 99, 12084, Mondovì, Italy.
Fabio ZanchiniClinical Orthopaedics, University of Campania "Luigi Vanvitelli", via L. de Crecchio 4, 80138, Naples, Italy.
Gabriele ColòDepartment of Orthopaedics and Traumatology, Regional Center for Joint Arthroplasty, ASO Alessandria, Via Venezia 16, 16121, Alessandria, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to evaluate 30-60-90-day mortality of operated proximal femur fractures (PFFs) suffering from COVID-19 and correlation with patients' clinical presentation and comorbidities.

methodsBetween February 1, 2020, and December 31, 2020, patients with COVID-19 infection and surgically treated PFF were included. Patients' demographic characteristics, oxygen (O2) therapy, comorbidities, and AO type fracture were collected. Chi-square test or Fisher test and hazard ratio were used to assessing the correlation between mortality rate, patient characteristics, and COVID-19 status. Kaplan-Meyer curve was used to analyze 30-60-90-day mortality. Level of significance was set as p < 0.05.

resultsFifty-six patients (mean age of 82.7 ± 8.85 years) were included. Thirty-day mortality rate was 5%, which increased to 21% at 60 days and 90 days. Eleven patients died, eight due to AO type A-like and three due to AO type B-like fractures. No significant difference in mortality rate between patients with cardiopulmonary comorbidity or no cardiopulmonary comorbidity was found (p = 0.67); a significant difference in patients with chronic obstructive pulmonary disease (COPD) or history of pulmonary embolism (PE) and patients without COPD was found (p = 0.0021). A significant difference between asymptomatic/mild symptomatic COVID-19 status and symptomatic COVID-19 status was found (p = 0.0415); a significant difference was found for O2 therapy with < 4 L/min and O2 therapy ≥ 4 L/min (p = 0.0049).

conclusionThirty-day mortality rate of COVID-19 infection and PFFs does not differ from mortality rate of non-COVID-19 PFFs. However, patients with pre-existing comorbidities and symptomatic COVID-19 infection requiring a high volume of O2 therapy have a higher incidence of 60-90-day mortality when surgically treated.

Indexed as

COVID-19Femoral FracturesHip FracturesAgedAged, 80 and overComorbidityHumansItalyRetrospective StudiesSARS-CoV-2Coronavirus diseaseFractureHipIntramedullary nailingJoint replacementProximal femur

Identifiers

PMID34401931
PMCPMC8366488

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.