{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T17:48:39Z","timestamp":1765820919887,"version":"3.48.0"},"reference-count":72,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T00:00:00Z","timestamp":1693785600000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,8,16]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess across seven hospitals from six different countries the extent to which the COVID-19 pandemic affected the volumes of orthopaedic hospital admissions and patient outcomes for non-COVID-19 patients admitted for orthopaedic care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A multi-centre interrupted time series (ITS) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Seven hospitals from six countries who collaborated within the Global Health Data@Work collaborative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Non-COVID-19 patients admitted for orthopaedic care during the pre-pandemic (January\/2018\u2013February\/2020) and COVID-19 pandemic (March\/2020\u2013June\/2021) period. Admissions were categorised as: (1) acute admissions (lower limb fractures\/neck of femur fractures\/pathological fractures\/joint dislocations\/upper limb fractures); (2) subacute admissions (bone cancer); (3) elective admissions (osteoarthritis).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Monthly observed versus expected ratios (O\/E) were calculated for in-hospital mortality, long (upper-decile) length-of-stay and hospital readmissions, with expected rates calculated based on case-mix. An ITS design was used to estimate the change in level and\/or trend of the monthly O\/E ratio by comparing the COVID-19 pandemic with the pre-pandemic period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>69\u2009221 (pre-pandemic) and 22\u2009940 (COVID-19 pandemic) non-COVID-19 orthopaedic patient admissions were included. Admission volumes were reduced during the COVID-19 pandemic for all admission categories (range: 33%\u201345%), with more complex patients treated as shown by higher percentages of patients admitted with \u22651 comorbidity (53.8% versus 49.8%, p&lt;0.001). The COVID-19 pandemic was not associated with significant changes in patient outcomes for most diagnostic groups. Only for patients diagnosed with pathological fractures (pre-pandemic n=1671\u2009and pandemic n=749), the COVID-19 pandemic was significantly associated with an immediate mortality reduction (level change of \u221277.7%, 95%\u2009CI \u2212127.9% to \u221225.7%) and for lower limb fracture patients (pre-pandemic n=9898\u2009and pandemic n=3307) with a significantly reduced trend in readmissions (trend change of \u22126.3% per month, 95%\u2009CI \u221211.0% to \u22121.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acute, subacute, as well as elective orthopaedic hospital admissions volumes were reduced in all global participating hospitals during the COVID-19 pandemic, while overall patient outcomes for most admitted non-COVID-19 patients remained the same despite the strain caused by the surge of COVID-19 patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-073276","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T12:50:33Z","timestamp":1693831833000},"page":"e073276","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes of non-COVID-19 orthopaedic patients admitted during the COVID-19 pandemic: a multi-centre interrupted time series analysis across hospitals in six different countries"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5343-6965","authenticated-orcid":false,"given":"Lotje Anna","family":"Hoogervorst","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Department of Biomedical Data Sciences & Medical Decision Making, Leiden University Medical Centre, Leiden, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter","family":"Stijnen","sequence":"additional","affiliation":[{"name":"Department of Management Information and Reporting, Universitaire Ziekenhuizen Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Albini","sequence":"additional","affiliation":[{"name":"Department of Quality Monitoring, Humanitas Group, Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Janda","sequence":"additional","affiliation":[{"name":"Global Health Data@Work, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Stewardson","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob G H H","family":"Nelissen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1439-0989","authenticated-orcid":false,"given":"Perla","family":"Marang-van de Mheen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences & Medical Decision Making, Leiden University Medical Centre, Leiden, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,9,4]]},"reference":[{"key":"2025121509453740000_13.9.e073276.1","doi-asserted-by":"crossref","unstructured":"Barahona M , Infante CA , Palet MJ , et al . Impact of the COVID-19 outbreak on orthopedic surgery: A nationwide analysis of the first pandemic year. Cureus 2021. doi:10.7759\/cureus.17252","DOI":"10.7759\/cureus.17252"},{"key":"2025121509453740000_13.9.e073276.2","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-021-02286-9","article-title":"Full recovery of elective orthopedic surgery in the age of COVID-19: an 8-month retrospective cohort study","volume":"16","author":"Lou","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"2025121509453740000_13.9.e073276.3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s00590-020-02748-6","article-title":"The impact of the COVID-19 pandemic on Orthopaedic services and training in the UK","volume":"31","author":"Khan","year":"2021","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"2025121509453740000_13.9.e073276.4","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.20.00775","article-title":"Impact of COVID-19 on Orthopaedic and trauma service: an Epidemiological study","volume":"102","author":"Wong","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"2025121509453740000_13.9.e073276.5","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1007\/s00264-020-04590-1","article-title":"Changes of clinical activities in an Orthopaedic Institute in North Italy during the spread of COVID-19 pandemic: a seven-week observational analysis","volume":"44","author":"Zagra","year":"2020","journal-title":"International Orthopaedics (SICOT)"},{"key":"2025121509453740000_13.9.e073276.6","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-020-01740-4","article-title":"COVID-19 strategy in organizing and planning orthopedic surgery in a major orthopedic referral center in an area of Italy severely affected by the pandemic: experience of the Department of Orthopedics, University of Padova","volume":"15","author":"Ruggieri","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"2025121509453740000_13.9.e073276.7","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2020.1783621"},{"key":"2025121509453740000_13.9.e073276.8","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.21.00833","article-title":"Elective inpatient total joint Arthroplasty case volume in the United States in 2020: effects of the COVID-19 pandemic","volume":"104","author":"Heckmann","year":"2022","journal-title":"J Bone Joint Surg Am"},{"key":"2025121509453740000_13.9.e073276.9","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.20.00756","article-title":"Impact of the COVID-19 pandemic on Orthopaedic and trauma surgery in university hospitals in Germany: results of a nationwide survey","volume":"102","author":"Haffer","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"2025121509453740000_13.9.e073276.10","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.20.00604","article-title":"Disruptive effect of COVID-19 on Orthopaedic daily practice: A cross-sectional survey","volume":"102","author":"Ranuccio","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"2025121509453740000_13.9.e073276.11","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.20.00602","article-title":"SARS-Cov-2 impact on elective Orthopaedic surgery: implications for post-pandemic recovery","volume":"102","author":"Jain","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"2025121509453740000_13.9.e073276.12","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-021-02283-y","article-title":"COVID-19 pandemic effects on Orthopaedic Surgeons in British Columbia","volume":"16","author":"Simon","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"2025121509453740000_13.9.e073276.13","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1302\/2633-1462.312.BJO-2022-0111.R1","article-title":"No time to waste; the impact of the COVID-19 pandemic on hip, knee, and shoulder Arthroplasty surgeries in the Netherlands and Denmark","volume":"3","author":"Latijnhouwers","year":"2022","journal-title":"Bone Jt Open"},{"key":"2025121509453740000_13.9.e073276.14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-054919","article-title":"Impact of COVID-19 on acute trauma and Orthopaedic referrals and surgery in the UK during the first wave of the pandemic: a Multicentre observational study from the Covid emergency-related trauma and Orthopaedics (COVERT) collaborative","volume":"12","author":"Sugand","year":"2022","journal-title":"BMJ Open"},{"key":"2025121509453740000_13.9.e073276.15","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-021-02754-2","article-title":"Comparative study between admission, Orthopaedic surgery, and economic trends during COVID-19 and non-COVID-19 pandemic in an Italian tertiary hospital: a retrospective review","volume":"16","author":"Testa","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"2025121509453740000_13.9.e073276.16","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1302\/0301-620X.103B.BJJ-2020-2027.R1","article-title":"IMPACT-Scot 2 report on COVID-19 in hip fracture patients","volume":"103-B","author":"Hall","year":"2021","journal-title":"Bone Joint J"},{"key":"2025121509453740000_13.9.e073276.17","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1302\/0301-620X.102B10.BJJ-2020-1774","article-title":"The effects of COVID-19 on perioperative morbidity and mortality in patients with hip fractures","volume":"102-B","author":"Kayani","year":"2020","journal-title":"Bone Joint J"},{"key":"2025121509453740000_13.9.e073276.18","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1302\/0301-620X.104B10.BJJ-2022-0082.R1","article-title":"The impact of COVID-19 on mortality after hip fracture: a population cohort study from England","volume":"104-B","author":"Holleyman","year":"2022","journal-title":"Bone Joint J"},{"key":"2025121509453740000_13.9.e073276.19","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1302\/0301-620X.102B9.BJJ-2020-1100.R1","article-title":"IMPACT-Scot report on COVID-19 and hip fractures","volume":"102-B","author":"Hall","year":"2020","journal-title":"Bone Joint J"},{"key":"2025121509453740000_13.9.e073276.20","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1302\/0301-620X.102B12.BJJ-2020-1395.R2","article-title":"IMPACT-restart: the influence of COVID-19 on postoperative mortality and risk factors associated with SARS-Cov-2 infection after Orthopaedic and trauma surgery","volume":"102-B","author":"Clement","year":"2020","journal-title":"The Bone & Joint Journal"},{"key":"2025121509453740000_13.9.e073276.21","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-021-02382-w","article-title":"Delayed hospital admission for traumatic hip fractures during the COVID-19 pandemic","volume":"16","author":"Jarvis","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"2025121509453740000_13.9.e073276.22","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-021-02301-z","article-title":"The impact of COVID-19 on the management and outcomes of patients with proximal femoral fractures: a multi-centre study of 580 patients","volume":"16","author":"Wignall","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"2025121509453740000_13.9.e073276.23","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1302\/0301-620X.103B.BJJ-2020-1862.R1","article-title":"Coronavirus infection in hip fractures (CHIP) study","volume":"103-B","author":"Mahmood","year":"2021","journal-title":"Bone Joint J"},{"key":"2025121509453740000_13.9.e073276.24","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1302\/0301-620X.103B.BJJ-2020-1776.R1","article-title":"The rate of COVID-19 and associated mortality after elective hip and knee Arthroplasty prior to cessation of elective services in UK","volume":"103-B","author":"Clement","year":"2021","journal-title":"Bone Joint J"},{"key":"2025121509453740000_13.9.e073276.25","unstructured":"Care ACoSaQiH . Using hospital mortality indicators to improve patient care: A guide for boards and chief executives. 2001."},{"key":"2025121509453740000_13.9.e073276.26","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6963-9-186","article-title":"Quality of care and 30 day mortality among patients with hip fractures: a nationwide cohort study","volume":"9","author":"Nielsen","year":"2009","journal-title":"BMC Health Serv Res"},{"key":"2025121509453740000_13.9.e073276.27","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzw093"},{"key":"2025121509453740000_13.9.e073276.28","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-014190","article-title":"Moppett IK: does achieving the best practice tariff improve outcomes in hip fracture patients? an observational cohort study","volume":"7","author":"Oakley","year":"2017","journal-title":"BMJ Open"},{"key":"2025121509453740000_13.9.e073276.29","doi-asserted-by":"crossref","first-page":"751","DOI":"10.2106\/JBJS.17.00884","article-title":"Quality of care in hip fracture patients: the relationship between adherence to national standards and improved outcomes","volume":"100","author":"Farrow","year":"2018","journal-title":"J Bone Joint Surg Am"},{"key":"2025121509453740000_13.9.e073276.30","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-018-4558-x"},{"key":"2025121509453740000_13.9.e073276.31","doi-asserted-by":"crossref","first-page":"138","DOI":"10.2340\/17453674.2021.861","article-title":"A more comprehensive evaluation of quality of care after total hip and knee Arthroplasty: combining 4 indicators in an ordered composite outcome","volume":"93","author":"Van Schie","year":"2022","journal-title":"Acta Orthop"},{"key":"2025121509453740000_13.9.e073276.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2014.12.018"},{"key":"2025121509453740000_13.9.e073276.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.05.026"},{"key":"2025121509453740000_13.9.e073276.34","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2710.2002.00430.x"},{"key":"2025121509453740000_13.9.e073276.35","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v91i1.9397"},{"key":"2025121509453740000_13.9.e073276.36","unstructured":"Beamtree launches new global health Comparators collaborative, Available: https:\/\/beamtree.com.au\/our-solutions\/global-health-comparators\/"},{"key":"2025121509453740000_13.9.e073276.37","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-017-1569-2","article-title":"Variation in prosthetic joint infection and treatment strategies during 4.5 years of follow-up after primary joint Arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals","volume":"18","author":"Marang-van de Mheen","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"2025121509453740000_13.9.e073276.38","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"2025121509453740000_13.9.e073276.39","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw098"},{"key":"2025121509453740000_13.9.e073276.40","doi-asserted-by":"crossref","DOI":"10.3390\/s21217333","article-title":"Time series Segmentation based on Stationarity analysis to improve new samples prediction","volume":"21","author":"Silva","year":"2021","journal-title":"Sensors (Basel)"},{"key":"2025121509453740000_13.9.e073276.41","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0164110","article-title":"Determining the Stationarity distance via a reversible stochastic process","volume":"11","author":"Poulos","year":"2016","journal-title":"PLoS One"},{"key":"2025121509453740000_13.9.e073276.42","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-021-01364-0"},{"key":"2025121509453740000_13.9.e073276.43","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001845"},{"key":"2025121509453740000_13.9.e073276.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.05.016"},{"key":"2025121509453740000_13.9.e073276.45","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.jor.2020.06.018","article-title":"Management of hip fractures during the COVID-19 pandemic at a high-volume hip fracture unit in the United Kingdom","volume":"20","author":"Malik-Tabassum","year":"2020","journal-title":"J Orthop"},{"key":"2025121509453740000_13.9.e073276.46","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1016\/j.injury.2020.06.006","article-title":"The evolving COVID-19 effect on hip fracture patients","volume":"51","author":"Hadfield","year":"2020","journal-title":"Injury"},{"key":"2025121509453740000_13.9.e073276.47","doi-asserted-by":"crossref","first-page":"7619","DOI":"10.18632\/aging.103201","article-title":"Preventive strategy for the clinical treatment of hip fractures in the elderly during the COVID-19 outbreak: Wuhan\u2019s experience","volume":"12","author":"Liu","year":"2020","journal-title":"Aging"},{"key":"2025121509453740000_13.9.e073276.48","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.20.00686","article-title":"Mortality rates of patients with proximal femoral fracture in a worldwide pandemic: preliminary results of the Spanish HIP-COVID observational study","volume":"102","author":"Mu\u00f1oz Vives","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"2025121509453740000_13.9.e073276.49","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s00264-020-04739-y","article-title":"Thirty-day mortality following surgical management of hip fractures during the COVID-19 pandemic: findings from a prospective multi-centre UK study","volume":"45","author":"Narang","year":"2021","journal-title":"Int Orthop"},{"key":"2025121509453740000_13.9.e073276.50","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1007\/s00264-020-04769-6","article-title":"Prolonged social Lockdown during COVID-19 pandemic and hip fracture epidemiology","volume":"44","author":"Slullitel","year":"2020","journal-title":"International Orthopaedics (SICOT)"},{"key":"2025121509453740000_13.9.e073276.51","doi-asserted-by":"crossref","unstructured":"Lemos JL , Welch JM , Xiao M , et al . Is frailty associated with adverse outcomes after Orthopaedic surgery?: A systematic review and assessment of definitions. JBJS Rev 2021;9. doi:e21.00065","DOI":"10.2106\/JBJS.RVW.21.00065"},{"key":"2025121509453740000_13.9.e073276.52","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16976"},{"key":"2025121509453740000_13.9.e073276.53","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31786-6"},{"key":"2025121509453740000_13.9.e073276.54","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1111\/imj.12502","article-title":"Can frailty predict complicated care needs and length of stay","volume":"44","author":"Rose","year":"2014","journal-title":"Intern Med J"},{"key":"2025121509453740000_13.9.e073276.55","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1007\/s12603-012-0369-5","article-title":"Frailty is associated with longer hospital stay and increased mortality in hospitalized older patients","volume":"16","author":"Khandelwal","year":"2012","journal-title":"J Nutr Health Aging"},{"key":"2025121509453740000_13.9.e073276.56","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-018-1935-8","article-title":"Frailty as a Predictor of hospital length of stay after elective total joint replacements in elderly patients","volume":"19","author":"Wang","year":"2018","journal-title":"BMC Musculoskelet Disord"},{"key":"2025121509453740000_13.9.e073276.57","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.medmal.2019.01.012","article-title":"Multifactorial immunodeficiency in frail elderly patients: contributing factors and management","volume":"49","author":"Tannou","year":"2019","journal-title":"Med Mal Infect"},{"key":"2025121509453740000_13.9.e073276.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.05.073"},{"key":"2025121509453740000_13.9.e073276.59","doi-asserted-by":"crossref","DOI":"10.1017\/S0950268822000334","article-title":"Factors influencing SARS-Cov-2 infection rate in Belgian nursing home residents during the first wave of COVID-19 pandemic","volume":"150","author":"Peckeu-Abboud","year":"2022","journal-title":"Epidemiol Infect"},{"key":"2025121509453740000_13.9.e073276.60","doi-asserted-by":"crossref","DOI":"10.1186\/s13690-022-00794-6","article-title":"Hannecart A et al: COVID-19 cases, hospitalizations and deaths in Belgian nursing homes: results of a surveillance conducted between April and December 2020","volume":"80","author":"Vandael","year":"2022","journal-title":"Arch Public Health"},{"key":"2025121509453740000_13.9.e073276.61","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1177\/1120700019835160","article-title":"Causes of in-hospital mortality after hip fractures in the elderly","volume":"30","author":"Groff","year":"2020","journal-title":"Hip Int"},{"key":"2025121509453740000_13.9.e073276.62","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2011.06.002"},{"key":"2025121509453740000_13.9.e073276.63","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-018-2916-1","article-title":"Evaluation of hospital outcomes: the relation between length-of-stay, readmission, and mortality in a large International administrative database","volume":"18","author":"Lingsma","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"2025121509453740000_13.9.e073276.64","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1089\/pop.2020.0138","article-title":"Thow AM: onslaught of COVID-19: how did governments react and at what point of the crisis","volume":"24","author":"Uddin","year":"2021","journal-title":"Popul Health Manag"},{"key":"2025121509453740000_13.9.e073276.65","unstructured":"COVID-19 government measures Dataset. n.d. Available: https:\/\/data.humdata.org\/dataset\/acaps-covid19-government-measures-dataset?"},{"key":"2025121509453740000_13.9.e073276.66","unstructured":"WHO Coronavirus (COVID-19) dashboard. n.d. Available: https:\/\/covid19.who.int\/"},{"key":"2025121509453740000_13.9.e073276.67","doi-asserted-by":"crossref","first-page":"197","DOI":"10.2147\/CLEP.S176723","article-title":"Sample size and power considerations for ordinary least squares interrupted time series analysis: a simulation study","volume":"11","author":"Hawley","year":"2019","journal-title":"Clin Epidemiol"},{"key":"2025121509453740000_13.9.e073276.68","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jclinepi.2016.04.004","article-title":"New ICD-10 version of the multipurpose Australian Comorbidity scoring system outperformed Charlson and Elixhauser Comorbidities in an older population","volume":"79","author":"Toson","year":"2016","journal-title":"J Clin Epidemiol"},{"key":"2025121509453740000_13.9.e073276.69","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-020-04892-4"},{"key":"2025121509453740000_13.9.e073276.70","doi-asserted-by":"crossref","first-page":"e126","DOI":"10.1097\/BOT.0000000000001952","article-title":"Impact of frailty and malnutrition on outcomes after surgical fixation of lower extremity fractures in young patients","volume":"35","author":"Phen","year":"2021","journal-title":"J Orthop Trauma"},{"key":"2025121509453740000_13.9.e073276.71","unstructured":"WHO . Maintaining essential health services: operational guidance for the COVID-19 context: interim guidance. 2020."},{"key":"2025121509453740000_13.9.e073276.72","doi-asserted-by":"crossref","unstructured":"Braithwaite J . Quality of care in the COVID-19 era: a global perspective. IJQHC Communications 2021;1. doi:10.1093\/ijcoms\/lyab003","DOI":"10.1093\/ijcoms\/lyab003"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-073276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T17:45:53Z","timestamp":1765820753000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-073276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":72,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,4]]},"published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1136\/bmjopen-2023-073276"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-073276","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}