{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:28:27Z","timestamp":1787563707333,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T00:00:00Z","timestamp":1678492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The primary aim was to evaluate the impact of COVID\u201019 on frailty in patients surviving a hip fracture. Secondary aims were to assess impact of COVID\u201019 on (i) length of stay (LoS) and post\u2010discharge care needs, (ii) readmissions, and (iii) likelihood of returning to own home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This propensity score\u2010matched case\u2010control study was conducted in a single centre between 01\/03\/20\u201330\/11\/21. A \u2018COVID\u2010positive\u2019 group of 68 patients was matched to 141 \u2018COVID\u2010negative\u2019 patients. \u2018Index\u2019 and \u2018current\u2019 Clinical Frailty Scale (CFS) scores were assigned for frailty at admission and at follow\u2010up. Data were extracted from validated records and included: demographics, injury factors, COVID\u201019 status, delirium status, discharge destination, and readmissions. For subgroup analysis controlling for vaccination availability, the periods 1 March 2020\u201330 November 2020 and 1 February 2021\u201330 November 2021 were considered pre\u2010\/post\u2010vaccine periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median age was 83.0\u00a0years, 155\/209 (74.2%) were female and median follow\u2010up was 479\u00a0days (interquartile range [IQR] 311). There was an equivalent median increase in CFS in both groups (+1.00 [IQR 1.00\u20132.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.472]). However, adjusted analysis demonstrated COVID\u201019 was independently associated with a greater magnitude change (Beta coefficient [\n                      <jats:italic>\u03b2<\/jats:italic>\n                      ] 0.27, 95% confidence interval [95% CI] 0.00\u20130.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.05). COVID\u201019 in the post\u2010vaccine availability period was associated with a smaller increase versus pre\u2010vaccine (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u22120.64, 95% CI \u22121.20 to \u22120.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.023). COVID\u201019 was independently associated with increased acute LoS (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      4.40, 95% CI 0.22\u20138.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.039), total LoS (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      32.87, 95% CI 21.42\u201344.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), readmissions (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      0.71, 95% CI 0.04\u20131.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.039), and a four\u2010fold increased likelihood of pre\u2010fracture home\u2010dwelling patients failing to return home (odds ratio 4.52, 95% CI 2.08\u201310.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hip fracture patients that survived a COVID\u201019 infection had increased frailty, longer LoS, more readmissions, and higher care needs. The health and social care burden is likely to be higher than prior to the COVID\u201019 pandemic. These findings should inform prognostication, discharge\u2010planning, and service design to meet the needs of these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/msc.1753","type":"journal-article","created":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T12:49:26Z","timestamp":1678538966000},"page":"786-796","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["COVID\u201019 is associated with increased care needs and a decreased likelihood of returning home following a hip fracture: The IMPACT frailty study"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4582-8368","authenticated-orcid":false,"given":"Andrew J.","family":"Hall","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Golden Jubilee University National Hospital  Clydebank UK"},{"name":"Edinburgh Orthopaedics Royal Infirmary of Edinburgh  Edinburgh UK"},{"name":"Department of Orthopaedics &amp; Trauma Usher Institute University of Edinburgh  Edinburgh UK"},{"name":"Scottish Orthopaedic Research Trust Into Trauma (SORT\u2010IT)  Edinburgh UK"},{"name":"Scottish Hip Fracture Audit (SHFA) NHS National Services Scotland  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8792-0659","authenticated-orcid":false,"given":"Nick D.","family":"Clement","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics Royal Infirmary of Edinburgh  Edinburgh UK"},{"name":"Scottish Orthopaedic Research Trust Into Trauma (SORT\u2010IT)  Edinburgh UK"},{"name":"Scottish Hip Fracture Audit (SHFA) NHS National Services Scotland  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Kay","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics Royal Infirmary of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7023-7108","authenticated-orcid":false,"given":"Rose S.","family":"Penfold","sequence":"additional","affiliation":[{"name":"Scottish Hip Fracture Audit (SHFA) NHS National Services Scotland  Edinburgh UK"},{"name":"Ageing and Health Group Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3159-9370","authenticated-orcid":false,"given":"Alasdair M. J.","family":"MacLullich","sequence":"additional","affiliation":[{"name":"Scottish Hip Fracture Audit (SHFA) NHS National Services Scotland  Edinburgh UK"},{"name":"Ageing and Health Group Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6125-7112","authenticated-orcid":false,"given":"Timothy O.","family":"White","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics Royal Infirmary of Edinburgh  Edinburgh UK"},{"name":"Department of Orthopaedics &amp; Trauma Usher Institute University of Edinburgh  Edinburgh UK"},{"name":"Scottish Orthopaedic Research Trust Into Trauma (SORT\u2010IT)  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5317-1300","authenticated-orcid":false,"given":"Andrew D.","family":"Duckworth","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics Royal Infirmary of Edinburgh  Edinburgh UK"},{"name":"Department of Orthopaedics &amp; Trauma Usher Institute University of Edinburgh  Edinburgh UK"},{"name":"Scottish Orthopaedic Research Trust Into Trauma (SORT\u2010IT)  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/GERONA\/62.10.1127"},{"issue":"2","key":"e_1_2_11_3_1","first-page":"17","article-title":"The Caldicott report","volume":"40","author":"Caldicott F.","year":"1999","journal-title":"Institute of Health Record Information and Management"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046\u20103758.912.BJR\u20102020\u20100473.R1"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","unstructured":"D'Agostino R.(1998).Propensity score methods for bias reduction in the comparison of a treatment to a non\u2010randomized control group. 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