PropertyValue
?:abstract
  • Aims: Hip fracture patients are at higher risk of severe COVID-19 illness, and admission into hospital puts them at further risk. We implemented a two-site orthopaedic trauma service, with \'COVID\' and \'COVID-free\' hubs, to deliver urgent and infection-controlled trauma care for hip fracture patients, while increasing bed capacity for medical patients during the COVID-19 pandemic. Methods: A vacated private elective surgical centre was repurposed to facilitate a two-site, \'COVID\' and \'COVID-free\', hip fracture service. Patients were screened for COVID-19 infection and either kept at our \'COVID\' site or transferred to our \'COVID-free\' site. We collected data for 30 days on patient demographics, Clinical Frailty Scale (CFS), Nottingham Hip Fracture Scores (NHFS), time to surgery, COVID-19 status, mortality, and length of stay (LOS). Results: In all, 47 hip fracture patients presented to our service: 12 were admitted to the \'COVID\' site and 35 to the \'COVID-free\' site. The \'COVID\' site cohort were older (mean 86.8 vs 78.5 years, p = 0.0427) and with poorer CFS (p = 0.0147) and NHFS (p = 0.0023) scores. At the \'COVID-free\' site, mean time to surgery was less (29.8 vs 52.8 hours, p = 0.0146), and mean LOS seemed shorter (8.7 vs 12.6 days, p = 0.0592). No patients tested positive for COVID-19 infection while at the \'COVID-free\' site. We redirected 74% of our admissions from the base \'COVID\' site and created 304 inpatient days\' capacity for medical COVID patients. Conclusion: Acquisition of unused elective orthopaedic capacity from the private sector facilitated a two-site trauma service. Patients were treated expeditiously, while successfully achieving strict infection control. We achieved significant gains in medical bed capacity in response to the COVID-19 demand. The authors propose the repurposing of unused elective operating facilities for a two-site \'COVID\' and \'COVID-free\' model as a safe and effective way of managing hip fracture patients during the pandemic.Cite this article: Bone Joint Open 2020;1-6:190-197.
is ?:annotates of
?:creator
?:journal
  • Bone_Jt_Open
?:license
  • unk
?:publication_isRelatedTo_Disease
is ?:relation_isRelatedTo_publication of
?:source
  • WHO
?:title
  • Evaluating the efficacy of a two-site (\'COVID-19\' and \'COVID-19-free\') trauma and orthopaedic service for the management of hip fractures during the COVID-19 pandemic in the UK
?:type
?:who_covidence_id
  • #940049
?:year
  • 2020

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