Alma B Pedersen, Nickolaj Risbo, Bjarke L Viberg, Henrik Palm, Niels Dieter Röck

Incidence, quality of care, and mortality in hip fracture patients in the course of the COVID pandemic. A population-based cohort study

  • Geriatrics and Gerontology
  • Aging
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Abstract Background We assessed the incidence, quality of in-hospital care and mortality for hip fracture (HF) patients in Denmark before and during the COVID pandemic. Methods We obtained data from the Danish registries in the COVID period (11 March 2020 to 27 January 2021, overall and in five periods) and compared to a pre-COVID period (13 March 2019 to 10 March 2020). We calculated the proportion of patients (%) that have fulfilled all the relevant quality indicators (a composite score of 100%) and adjusted hazard ratios (HR) with 95% confidence interval (CI) for 30-day mortality. Results The incidence of HF was 5.7 per 1000 person years both in pre-COVID and COVID period. About 35% of patients had a composite score of 100% in the COVID period compared to 28% in the pre-COVID period (proportion ratio 1.23 (95% CI: 1.17-1.30)). Fulfilment of all individual quality indicators was similar or higher in the COVID. 30-day mortality was 9.5% in pre-COVID period, compared to 10.8% in the COVID period (HR 1.15 (95% CI: 1.02-1.30)). HRs varied from 1.07 (95% CI: 0.89-1.29) to 1.31 (95% CI: 1.06-1.62) in five COVID periods. In-hospital mortality was 4% in pre-COVID vs. 4.4% in COVID period. Conclusions The incidence of HF in Denmark remained unchanged. The quality of in-hospital care was higher in the COVID compared to pre-COVID period. Unfortunately, 30-day mortality was also higher, highlighting the importance of recognizing diversity of social networks, home support, and digital health intervention after discharge for outcome of HF patients.

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