Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic

Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic

Abstract Incidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcar...

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Autores principales: Firas J. Raheman, Djamila M. Rojoa, Jvalant Nayan Parekh, Reshid Berber, Robert Ashford
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/97dda3f533a94500893fd094c9dae7f2
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spelling oai:doaj.org-article:97dda3f533a94500893fd094c9dae7f22021-12-02T15:42:59ZMeta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic10.1038/s41598-021-89617-22045-2322https://doaj.org/article/97dda3f533a94500893fd094c9dae7f22021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89617-2https://doaj.org/toc/2045-2322Abstract Incidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.Firas J. RahemanDjamila M. RojoaJvalant Nayan ParekhReshid BerberRobert AshfordNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-21 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Firas J. Raheman
Djamila M. Rojoa
Jvalant Nayan Parekh
Reshid Berber
Robert Ashford
Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
description Abstract Incidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.
format article
author Firas J. Raheman
Djamila M. Rojoa
Jvalant Nayan Parekh
Reshid Berber
Robert Ashford
author_facet Firas J. Raheman
Djamila M. Rojoa
Jvalant Nayan Parekh
Reshid Berber
Robert Ashford
author_sort Firas J. Raheman
title Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_short Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_full Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_fullStr Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_full_unstemmed Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic
title_sort meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the covid-19 pandemic
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/97dda3f533a94500893fd094c9dae7f2
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