Clinical trial NCT04882670: COVID-19 Pandemic on Health Care and Rehabilitation Outcomes
Official title: The Impact of the COVID-19 Pandemic on Health Care and Rehabilitation Outcomes in Frail Patients With a Hip Fracture. A Retrospective Prognostic Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Hip Fractures
Covid19
Lead sponsor: Istituto Ortopedico Rizzoli
Sponsor class: OTHER
First posted: 2021-05-12
Enrollment: 360
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: hip fracture patients who are admitted to the emergency room of an orthopedic university hospital

Brief summary: Fragility fracture is easily associated with a clinical worsening of patients in terms of quality of life and disability in the medium and long term. Following this traumatic event, more than half of the patients are unable to recover pre-fracture motor skills such as the ability to walk. The impact of the COVID-19 pandemic on this type of patient has not been described and it is easy to hypothesize that, given their intrinsic frailty condition, they may have been significantly affected by changes in care pathways.

Detailed description: The global health emergency due to the spread of COVID-19 has caused unprecedented pressure on the health systems of the various countries involved. COVID-19 has had a direct impact on the health status of people with an extremely high number of ICU admissions and deaths, but it has also led to a series of equally strong indirect consequences as described in various fields by multiple authors. In order to cope with the great health demand linked to the epidemic, hospitals had to invest human and physical resources, subtracting them from other care activities: operating theaters, surgical and non-surgical departments and the related staff normally destined for patient care were redirected and relocated to the care of COVID patients.

In the field of orthopedic surgery in the first phase of the spread of the epidemic, all non-essential interventions have been postponed and for essential interventions specific paths have been created at hospitals capable of operating even during the pandemic. This organization has led to a reduction in the overall number of hospitalized patients but the number of old patients operated for hip fracture has not decreased. From the point of view of the impact of the COVID-19 pandemic on all patients operated for hip fracture with respect to the care outcomes during the postoperative hospital stay, the available data are lacking.

Eligibility criteria: Inclusion Criteria:

* Patients diagnosed with fragility hip fracture such as pertrochanteric fracture, femoral neck fracture and subtrochanteric fracture
* Age 65 or older

Exclusion Criteria:

* Patients diagnosed with a fragility hip fracture whose nursing record was not scanned at the time of the investigation
* Patients with fragility fractures of the diaphyseal and / or distal femur and acetabular fractures.

Primary outcomes:
measure: Incidence of pressure ulcer
timeFrame: through hospitalization, an average of 9 days
Secondary outcomes:
measure: Incidence of urinary infections
timeFrame: through hospitalization, an average of 9 days
measure: Number of accidental falls
timeFrame: through hospitalization, an average of 9 days
measure: Start day for walking
timeFrame: through hospitalization, an average of 9 days
measure: Level of independence
timeFrame: 5 days after surgery
Other outcomes:
Locations:
city: Bologna
country: Italy
facility: IRCCS Istituto Ortopedico Rizzoli
state: BO
Study officials:
References: