The Impact of COVID-19 on Hip Fracture Management in a Tertiary Referral Hospital; Pearls and Pitfalls.

Abstract Background COVID-19 has caused significant challenges in the provision of safe and effective healthcare globally. Safeguarding the management of frail older adults is imperative in hip fracture care moving forward. Aims This study aimed to compare clinical outcomes of hip fracture care during the COVID-19 pandemic with the same timeframe in 2019, following significant reconfigurations in hip fracture management pathways during the pandemic. Methods We conducted a retrospective study comparing all patients treated for a hip fracture between two timeframes; March 1st2020 - May 1st 2020 and March 1st 2019 – May 1st 2019. Data was collected using the Irish Hip Fracture Database and the UHL electronic patient administration system. Results 118 patients were included in the study; 60 patients in the COVID-19 cohort and 58 patients in the control cohort. Demographic characteristics were comparable between groups. Improvements in adherence to Irish Hip Fracture Standards were noted during the COVID-19 cohort, however they were not significant. Three patients tested positive for COVID-19 during the timeframe of interest. Their length of stay (LOS) was noticeably longer than the median LOS of both groups. A significant decrease in femoral nerve blocks was noted during the COVID-19 cohort (p = < 0.001). There was a trend towards higher inpatient mortality, 30 day mortality rates and 30 day readmission in the COVID-19 cohort which was not statistically significant. ConclusionsOur study demonstrates continued adherence to the Irish Hip Fracture Standards at our institution and suggests the necessary alterations in hip fracture management did not negatively impact patient outcomes during the COVID-19 pandemic.