• Thomas Barker, Joshua Thompson, James Corbett, Sim Johal, and Iain McNamara.
• Trauma and Orthopaedics Department, Norfolk and Norwich University Hospital, Norwich, UK. t.barker@doctors.org.uk.
• Eur J Trauma Emerg Surg. 2021 Oct 1; 47 (5): 1327-1334.

IntroductionHip fractures are the most common traumatic injury in the UK's elderly population. Patients are often extremely frail with multiple comorbidities and so are at high risk of death should they contract COVID-19. This study aims to quantify the effects of COVID-19 on patients presenting with hip fractures to the Norfolk and Norwich University Hospital (NNUH).MethodsThis is a single centre, prospective, observational cohort study of patients over the age of sixty admitted with a hip fracture to NNUH between March 24th and April 22nd, 2020 and comparing them retrospectively with controls in April 2019. Patients were followed up for 30 days; data collected includes demographics, COVID-19 PCR results, date/cause of death and other prognostic indicators.Results66 consecutive patients managed for hip fractures were included in the study. 30-day mortality increased from 8.5% in April 2019 to 18.2% in April 2020. The 30-day mortality rate was 80% for those patients who test positive for COVID-19 as an inpatient, and was 13.8% for patients COVID-19 negative and for those who were untested. Those admitted from a healthcare institution were more likely to test positive for COVID-19 and had a higher 30-day mortality (p = 0.04 & p = 0.006, respectively). Suspected COVID-19-positive patients at time of admission had a delayed time to theatre, 46.7 h versus 27.1 h (p = 0.007), however this had no significant effect on mortality (p = 0.7).ConclusionsThe combination of fragility hip fracture and COVID-19 is associated with poor outcomes. COVID-19 has also indirectly increased mortality in this patient group.© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

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