Older patients with proximal femur fractures and SARS-CoV-2 infection - An observational study

Mortality analyses of elderly patients with proximal femoral fracture during the pandemic: vaccination affects or not

PURPOSE

To evaluate the mortality rate, intensive care unit (ICU) referral, and Charlson comorbidity index (CCI) between different types of vaccinated and non-vaccinated patients operated on due to intertrochanteric femoral fracture (IFF) during the pandemic.

METHODS

Ninety-six patients (43 males, 53 females) who had proximal femur nails (PFN) for the IFF during the pandemic were included in the study. The patients were divided into four subgroups; non-vaccinated, and different types of vaccinated. Mortality rates, ICU referrals, and CCI relations were evaluated.

RESULTS

No significant difference was observed in terms of demographic data such as age, gender, side, CCI, and ICU referrals between the subgroups (p = 0.164, p = 0.546, p = 0.703, p = 0.771, p = 0.627 respectively). The mortality rate was significantly lower in the Sinovac + BioNTech subgroup (p = 0.044).

CONCLUSION

No relationship was found between mortality rate, ICU referral, and CCI in different types of vaccinated and non-vaccinated patient subgroups.

Orthopaedic cardiac considerations in emergency

Orthopaedic patients undergoing emergency orthopaedic surgery should be referred for cardiac evaluation only when they are symptomatic or when a specific cardiac intervention is expected to reduce the surgical risk. A preoperative delay of 24-48 h of emergency orthopaedic operations has been associated with increased mortality and poor functional status of the patients. Research in the preoperative setting is almost exclusively retrospective because randomized studies are difficult to be performed and pose serious ethical concerns. Moreover, inevitably, guidelines have a low level of evidence and do not always provide a straightforward framework for the preoperative care of the patients. This editorial revisits the most common clinical cardiology dilemmas for emergency orthopaedic surgery to explore controversies of current recommendations and elaborate on the role of echocardiography in the perioperative period in emergency orthopaedic surgery.