Coronavirus disease 2019 (COVID-19) markedly increased mortality in patients with hip fracture - A systematic review and meta-analysis

Michael Anthonius Lim, Raymond Pranata, Michael Anthonius Lim, Raymond Pranata

Abstract

Introduction: This systematic review and meta-analysis aimed to evaluate the prevalence of coronavirus disease 2019 (COVID-19) and its impact on mortality in patients with hip fracture.

Methods: We performed a systematic literature search in PubMed, Cochrane Central Database, and medRvix from inception up to July 13, 2020 on research articles that enrolled hip fracture patients who had information on COVID-19 and clinically validated definition of death.

Results: A total of 984 participants from 6 studies were included in our study. The pooled prevalence of COVID-19 was 9% [95% CI: 7-11%]. The mortality rate in patients with concomitant hip fracture and COVID-19 was found to be 36% (95% CI: 26-47%), whereas the mortality rate in hip fracture without COVID-19 is 2% (95% CI: 1-3%). Meta-analysis showed that COVID-19 was associated with a seven-fold increase in risk (RR 7.45 [95% CI: 2.72, 20.43], p < 0.001; I2: 68.6%) of mortality in patients with hip fracture. Regression-based Harbord's test showed no indication of small-study effects (p = 0.06).

Conclusion: The present meta-analysis showed that COVID-19 increased the risk of mortality in patients with hip fracture.

Trial registration: This study is registered with PROSPERO, July 21, 2020, number CRD42020199618. Available from https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020199618.

Keywords: COVID-19; Hip fracture; Hip surgery; Mortality; Proximal femur fracture.

Conflict of interest statement

The authors declare that they possess no commercial or financial relationships that could be construed as a potential conflict of interest.

© 2020 Delhi Orthopedic Association. All rights reserved.

Figures

Fig. 1
Fig. 1
PRISMA flowchart.
Fig. 2
Fig. 2
Prevalence of COVID-19 in patients with hip fracture.
Fig. 3
Fig. 3
Forest-plot showing the association between COVID-19 and mortality in patients with hip fracture.

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