Evidence-based approach to providing informed consent for hip fracture surgery during the COVID-19 era

Table 1 Patient demographics and baseline characteristics

Variable	Category	COVID-19 negative (n = 146)	COVID-19 positive (n = 51)	P value1
Age	-	77.3 ± 12.8	79.3 ± 11.0	0.31
Gender, n (%)	Female	92 (63)	28 (49)	0.08
	Male	54 (37)	26 (51)
ASA grade, n (%)	1 or 2	46 (32)	15 (29)	0.64
	3	64 (44)	20 (39)
	4	36 (25)	16 (31)
Number of comorbidities	-	3.0 ± 1.5	3.3 ± 1.7	0.23
Dementia, n (%)	No	93 (64)	36 (71)	0.37
	Yes	53 (36)	15 (29)
Mobility, n (%)	Independent	65 (47)	18 (36)	0.14
	Stick	48 (35)	16 (32)
	Frame	26 (19)	16 (32)
Admission haemoglobin (g/L)	-	116 ± 19	108 ± 18	0.02
Admission leucocytes (× 109/L)	-	1.1 [0.8, 1.3]	1.1 [0.7, 1.3]	0.50
Procedure, n (%)	Cannulated screw	16 (11)	4 (8)	0.28
	Dynamic hip screw	29 (20)	14 (28)
	Intramedullary nail	34 (23)	11 (22)
	Hemiarthroplasty	56 (39)	21 (42)
	Total hip replacement	10 (7)	0 (0)
Operative time	-	80 [65, 102]	71 [58, 83]	0.008
Surgeon level, n (%)	Senior house officer	4 (3)	0 (0)	0.48
	Registrar	102 (70)	32 (64)
	Associate specialist	11 (8)	5 (10)
	Consultant	28 (19)	26 (13)
Admission to surgery (d)	-	2 [1, 3]	3 [2, 5]	0.03
Anaesthesia, n (%)	General	80 (55)	30 (61)	0.46
	Spinal	65 (45)	19 (39)

Summary statistics are: mean ± SD, median [inter-quartile range] or number (percentage).

¹P values indicating the significance of the difference between coronavirus disease 2019 (COVID-19) positive and COVID-19 negative cohorts. COVID-19: Coronavirus disease 2019; ASA: American Society of Anaesthesiologists.

Table 2 Comparison of outcomes between coronavirus disease 2019 positive and coronavirus disease 2019 negative cohorts

Outcome	Analysis	Negative (n = 146), n (%)	Positive (n = 51), n (%)	Odds ratio2 (95%CI)	P value
Intensive care	Unadjusted	8 (5)	14 (27)	6.53 (2.55, 16.7)	< 0.001
Admission	Adjusted1	-	-	4.64 (1.59, 13.5)	0.005
30-d mortality	Unadjusted	14 (10)	15 (29)	3.93 (1.74, 8.89)	0.001
	Adjusted1	-	-	3.00 (1.22, 7.40)	0.02
		Negative (n = 146), Med [IQR]	Positive (n = 51), Med [IQR]	Hazard ratio2 (95%CI)
Length of stay	Unadjusted	9 [7, 13]	23 [19, 31]	0.28 (0.18, 0.42)	< 0.001
(d)	Adjusted1	-	-	0.26 (0.17, 0.42)	< 0.001

¹Adjusted for: gender, mobility, admission haemoglobin, operative time and time from admission to surgery.

²Expressed as outcome in the coronavirus disease 2019 (COVID-19) positive group relative to the outcome in the COVID-19 negative group.

Table 3 Postoperative complications in coronavirus disease 2019 positive patients

Complication	n (%)
Lower respiratory tract infection	18 (35.29)
Acute respiratory distress syndrome	7 (13.73)
Sepsis	7 (13.73)
Thromboembolic event	5 (9.80)
Acute kidney injury	5 (9.80)
Anaemia	4 (7.84)
Myocardial infarction	2 (3.92)
Urinary tract infection	2 (3.92)
Cellulitis/wound infection	2 (3.92)
Upper gastrointestinal bleed	1 (1.96)
None	13 (25.49)