Modification of a validated risk stratification tool to characterize geriatric hip fracture outcomes and optimize care in a post-covid-19 world
Journal of Orthopaedic Trauma Aug 25, 2020
Konda SR, Ranson RA, Solasz SJ, et al. - This study was attempted to illustrate how a risk assessment tool modified to account for the COVID-19 virus during the current global pandemic is able to provide a risk assessment for low-energy geriatric hip fracture patients and to serve a treatment algorithm for care of COVID-19 positive/suspected hip fractures patients that accounts for their elevated risk of morbidity and mortality. Between October 2014 and April 2020, 1278 patients treated for hip fractures, including 136 patients treated during the COVID-19 pandemic between February 1, 2020 and April 15, 2020. For specific disease processes, the Score for Trauma Triage in the Geriatric and Middle-Aged tool can be modified, in this case to account for the COVID-19 virus and serve a robust risk stratification tool that accounts for a heretofore unknown risk factor. In this susceptible trauma population, COVID-19 positive/suspected status portends a poor outcome and should be included in risk assessment models. These individuals should be recognized as a high risk for perioperative morbidity and mortality. The data demonstrate that individuals with COVID-19 symptoms on presentation should have surgery deferred until symptoms improve or resolve and should be reevaluated for surgical treatment vs definitive nonoperative treatment with palliative care and/or hospice care.
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