• J Orthop Trauma · Oct 2020

    Are Hospitals Safe? A Prospective Study on SARS-CoV-2 Prevalence and Outcome on Surgical Fracture Patients: A Closer Look at Hip Fracture Patients.

    • Borja Segarra, Nuria Ballesteros Heras, Marian Viadel Ortiz, Julio Ribes-Iborra, Olalla Martinez-Macias, and David Cuesta-Peredo.
    • Departments of Orthopaedic Surgery, and.
    • J Orthop Trauma. 2020 Oct 1; 34 (10): e371-e376.

    ObjectivesTo describe clinical characteristics of fracture patients, including a closer look to hip fracture patients, and determine how epidemiological variables may have influenced on a higher vulnerability to SARS-CoV-2 infection, as the basis for the considerations needed to reintroduce elective surgery during the pandemic.DesignLongitudinal prospective cohort study.SettingLevel I Trauma Center in the East of Spain.Patients/ParticipantsOne hundred forty-four consecutive fracture patients 18 years or older admitted for surgery.InterventionPatients were tested for SARS-CoV-2 with either molecular and/or serological techniques and screened for presentation of COVID-19.Main Outcome MeasurementsPatients were interviewed and charts reviewed for demographic, epidemiological, clinical, and surgical characteristics.ResultsWe interviewed all patients and tested 137 (95.7%) of them. Three positive patients for SARS-CoV-2 were identified (2.1%). One was asymptomatic and the other 2 required admission due to COVID-19-related symptoms. Mortality for the whole cohort was 13 patients (9%). Significant association was found between infection by SARS-CoV-2 and epidemiological variables including: intimate exposure to respiratory symptomatic patients (P = 0.025) and intimate exposure to SARS-CoV-2-positive patients (P = 0.013). No association was found when crowding above 50 people was tested individually (P = 0.187). When comparing the 2020 and 2019 hip fracture cohorts we found them to be similar, including 30-day mortality. A significant increase in surgical delay from 1.5 to 1.8 days was observed on the 2020 patients (P = 0.034).ConclusionsPatients may be treated safely at hospitals if strict recommendations are followed. Both cohorts of hip fracture patients had similar 30-day mortality.Level Of EvidencePrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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