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Introduction <p>Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and mortality increases in elderly patients with comorbidities. This study aims to examine the in-hospital complications and mortality for elderly patients with proximal femur fractures during the COVID-19 pandemic or countermeasure periods.</p> Materials and methods <p>The proximal femur fractures undergoing surgery during the COVID-19 pandemic or countermeasure period were compared with the pre-pandemic in a Japanese national inpatient data. The assessed outcomes were the development of pneumonia, deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality during hospitalization in two periods, and those for COVID-19-positive patients.</p> Results <p>A total of 284,922 proximal femur fractures aged over 65&#xa0;years were included. In the COVID-19 pandemic period compared to the pre-pandemic, the odds of pneumonia, DVT, PE, and mortality decreased to 0.942 (95% confidence interval [CI]: 0.901 − 0.986, <i>P</i> = 0.0102) and 0.839 (95% CI: 0.745 − 0.946, <i>P</i> = 0.004), increased to 1.153 (95% CI: 1.112 − 1.195, <i>P</i> &lt; 0.001), and 1.048 (95% CI: 0.982 − 1.118, <i>P</i> = 0.1554), respectively. For COVID-19 positivity at admission, the odds of PE increased significantly to 12.95 (95% CI: 8.795 − 19.06, <i>P</i> &lt; 0.001). For COVID-19 positivity during hospitalization, the odds of pneumonia and mortality were increased to 2.896 (95% CI: 1.820 − 4.608, <i>P</i> &lt; 0.001) and 6.303 (95% CI: 3.440 − 11.55, <i>P</i> &lt; 0.001), respectively.</p> Conclusion <p>These findings alert healthcare professionals and patients to the elevated complications, especially PE rate for proximal femoral fracture with COVID-19 positive.</p>

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Increased complications of proximal femur fractures during the COVID-19 pandemic: a nationwide medical claims database study in Japan

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月10日

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  • Hidetatsu Tanaka,
  • Kunio Tarasawa,
  • Yu Mori,
  • Kiyohide Fushimi,
  • Kenji Fujimori,
  • Toshimi Aizawa

摘要

Introduction

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and mortality increases in elderly patients with comorbidities. This study aims to examine the in-hospital complications and mortality for elderly patients with proximal femur fractures during the COVID-19 pandemic or countermeasure periods.

Materials and methods

The proximal femur fractures undergoing surgery during the COVID-19 pandemic or countermeasure period were compared with the pre-pandemic in a Japanese national inpatient data. The assessed outcomes were the development of pneumonia, deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality during hospitalization in two periods, and those for COVID-19-positive patients.

Results

A total of 284,922 proximal femur fractures aged over 65 years were included. In the COVID-19 pandemic period compared to the pre-pandemic, the odds of pneumonia, DVT, PE, and mortality decreased to 0.942 (95% confidence interval [CI]: 0.901 − 0.986, P = 0.0102) and 0.839 (95% CI: 0.745 − 0.946, P = 0.004), increased to 1.153 (95% CI: 1.112 − 1.195, P < 0.001), and 1.048 (95% CI: 0.982 − 1.118, P = 0.1554), respectively. For COVID-19 positivity at admission, the odds of PE increased significantly to 12.95 (95% CI: 8.795 − 19.06, P < 0.001). For COVID-19 positivity during hospitalization, the odds of pneumonia and mortality were increased to 2.896 (95% CI: 1.820 − 4.608, P < 0.001) and 6.303 (95% CI: 3.440 − 11.55, P < 0.001), respectively.

Conclusion

These findings alert healthcare professionals and patients to the elevated complications, especially PE rate for proximal femoral fracture with COVID-19 positive.