The epidemiology of proximal femur fractures during COVID-19 emergency in Italy: a multicentric study

The epidemiology of proximal femur fractures during COVID-19 emergency in Italy: a multicentric study

Authors

  • Corrado Ciatti Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy https://orcid.org/0000-0002-7094-4344
  • Pietro Maniscalco Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Fabrizio Quattrini Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Serena Gattoni Orthogeriatric Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Alessandra Magro Orthogeriatric Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Patrizio Capelli Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Filippo Banchini Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Caterina Fiazza Hospital Pharmacy, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Vito Pavone Orthopedics and Traumatology Department, University of Catania, Italy
  • Calogero Puma Pagliarello Orthopedics and Traumatology Department, University of Catania, Italy
  • Fabiana Valenti Orthopedics and Traumatology Department, University of Catania, Italy
  • Giulio Maccauro Orthopedics Department, IRCCS Fondazione Policlinico Gemelli, Rome, Italy
  • Michele Cauteruccio Orthopedics Department, IRCCS Fondazione Policlinico Gemelli, Rome, Italy
  • Riccardo Accetta Trauma Unit and Emergency Department, IRCCS Galeazzi Orthopedics Institute, Milano, Italy
  • Giuseppe Basile Trauma Unit and Emergency Department, IRCCS Galeazzi Orthopedics Institute, Milano, Italy
  • Carlo Ruosi Department of Orthopaedics, Federico II University, Napoli
  • Fabio Di Santo Orthopedics and Traumatology Department, AORN “Cardarelli” Hospital, Napoli
  • Nicola Orabona Orthopedics and Traumatology Department, ASL 1  “Ospedale del Mare “ Hospital, Napoli
  • Cristiano Coppola Orthopedics and Traumatology Department, ASL 1  “Ospedale del Mare “ Hospital, Napoli
  • Dario Perugia Orthopedics and Traumatology Department, San Camillo Forlanini Hospital, Rome, Italy
  • Riccardo Maria Lanzetti Orthopedics and Traumatology Department, San Camillo Forlanini Hospital, Rome, Italy
  • Mauro Roselli Orthopedic and Traumatology Unit, Maria Vittoria Hospital, Turin, Italy
  • Giuseppina Montanari Orthopedic and Traumatology Unit, Maria Vittoria Hospital, Turin, Italy
  • Francesco Benazzo Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
  • Mario Mosconi Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
  • Loris Perticarini Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
  • Vito Pesce U.O.C. di Ortopedia e Traumatologia Universitaria, Azienda Ospedaliero Universitaria Policlinico "Riuniti di Foggia", Dipartimento di Medicina Clinica e Sperimentale, Università di Medicina e Chirurgia Università di Foggia
  • Giuseppe Maccagnano U.O.C. di Ortopedia e Traumatologia Universitaria, Azienda Ospedaliero Universitaria Policlinico "Riuniti di Foggia", Dipartimento di Medicina Clinica e Sperimentale, Università di Medicina e Chirurgia Università di Foggia
  • Lorenzo Moretti School of Medicine, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, University of  Bari Aldo Moro, Bari, Italy
  • Biagio Moretti School of Medicine, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, University of  Bari Aldo Moro, Bari, Italy
  • Giuseppe Solarino School of Medicine, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, University of  Bari Aldo Moro, Bari, Italy

Keywords:

Covid-19, Proximal Femur Fracture, Multi-center Retrospective Study, Italian Covid Experience, Epidemiology, Anticoagulant, Antiaggregant

Abstract

Background and aim: After the first Italian case of Covid-19, the Government imposed the complete closure of all areas involved by the spread of the virus to contain transmissions. There was a massive reorganization of Hospitals, a stop of all elective activities and a convertion of many hospitals in “Covid Centers''. AITOG (Associazione Italiana Traumatologia e Ortopedia Geriatrica) conducted a retrospective study on all proximal femur fractures surgeries that occurred in this period, to find out whether the pandemic and the correlated lockdown somehow changed the incidence of these events. 

Methods: 10 Italian orthopedic centers were involved in the study. Considering the geographic location, three groups were created (North, Centre and South). The considered period is the Italian “Phase 1” (February 23rd - May 3rd 2020).

Results: the cohort is composed of 412 patients, 116 male and 296 female (mean age 81.1 ± 9.1 years). The same period of 2019 has been used as control group, with 558 patients, 156 male and 402 female (mean age 84.2 ± 8.0 years). In 2020 we counted 323 (78.4%) fractures occurred at home, 61 (14.8%) in retirement houses and 28 (6.8%) in different locations. We mainly treated fractures with intramedullary nails (n.237 57.5%). Among all patients we had 46 (11.1%) Covid-19 positive. The mortality rate within 30 days was of 51 patients (12.4%); 23 of these died because of complications related to Covid-19 while 31 of  these were in treatment with anticoagulant/antiaggregant.

Conclusions: AITOG analysis demonstrates a decrease in surgical interventions for proximal femur fractures from 2019 to 2020, a reduction in patients mean age and an increase in trauma occurred in domestic environment. We also registered a consistent difference between the North, Center and South of the Country.

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Published

05-11-2021

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Section

ORIGINAL INVESTIGATIONS/COMMENTARIES - SPECIAL COVID19

How to Cite

1.
The epidemiology of proximal femur fractures during COVID-19 emergency in Italy: a multicentric study. Acta Biomed [Internet]. 2021 Nov. 5 [cited 2024 Mar. 29];92(5):e2021398. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/11925