{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:53:41Z","timestamp":1785556421845,"version":"3.56.0"},"reference-count":26,"publisher":"Royal College of Surgeons of England","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> The COVID-19 pandemic presented extraordinary challenges to the UK healthcare system. This study aimed to assess the impact of the COVID-19 lockdown on the epidemiology, treatment pathways and 30-day mortality rates of hip fractures. Outcomes of COVID-19 positive patients were compared against those who tested negative. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> An observational, retrospective, multicentre study was conducted across six hospitals in the South East of England. Data were retrieved from the National Hip Fracture Database and electronic medical records. Data was collected for the strictest UK lockdown period (period B=23 March 2020\u201311 May 2020), and the corresponding period in 2019 (period A). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A total of 386 patients were admitted during period A, whereas 381 were admitted during period B. Despite the suspension of the \u2018Best Practice Tariff\u2019 during period B, time to surgery, time to orthogeriatric assessment, and 30-day mortality were similar between period A and B. The length of inpatient stay was significantly shorter during period B (11.5 days vs 17.0 days, p&lt;0.001). Comparison of COVID-19 positive and negative patients during period B demonstrated that a positive test was associated with a significantly higher rate of 30-day mortality (53.6% vs 6.7%), surgical delay &gt;36h (46.4% vs 30.8%, p=0.049), and increased length of inpatient stay (15.8 vs 11.7 days, p=0.015). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> The COVID-19 lockdown did not alter the epidemiology of hip fractures. A substantially higher mortality rate was observed among patients with a COVID-19 positive test. These findings should be taken into consideration by the healthcare policymakers while formulating contingency plans for a potential \u2018second wave\u2019. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2020.7071","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T08:54:17Z","timestamp":1615366457000},"page":"337-344","source":"Crossref","is-referenced-by-count":18,"title":["The effect of the COVID-19 lockdown on the epidemiology of hip fractures in the elderly: a multicentre cohort study"],"prefix":"10.1308","volume":"103","author":[{"given":"K","family":"Malik-Tabassum","sequence":"first","affiliation":[{"name":"East Sussex Healthcare NHS Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Robertson","sequence":"additional","affiliation":[{"name":"East Sussex Healthcare NHS Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BJ","family":"Tadros","sequence":"additional","affiliation":[{"name":"East Kent Hospitals University NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Chan","sequence":"additional","affiliation":[{"name":"Western Sussex Hospitals NHS Trust, UK"},{"name":"Brighton and Sussex Medical School, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Crooks","sequence":"additional","affiliation":[{"name":"East Sussex Healthcare NHS Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Buckle","sequence":"additional","affiliation":[{"name":"Brighton and Sussex University Hospitals NHS Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Rogers","sequence":"additional","affiliation":[{"name":"Brighton and Sussex University Hospitals NHS Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Selmon","sequence":"additional","affiliation":[{"name":"East Sussex Healthcare NHS Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Arealis","sequence":"additional","affiliation":[{"name":"East Kent Hospitals University NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"C1","unstructured":"COVID-19 Map. Johns Hopkins coronavirus resource center. https:\/\/coronavirus.jhu.edu\/map.html (cited November 2020)."},{"key":"C2","unstructured":"Cabinet Office. Staying at home and away from others (social distancing) - GOV.UK. https:\/\/www.gov.uk\/government\/publications\/full-guidance-on-staying-at-home-and-away-from-others (cited June 2020)."},{"key":"C3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.05.002"},{"key":"C4","unstructured":"The Nuffield Trust. Cancelled operations. https:\/\/www.nuffieldtrust.org.uk\/resource\/cancelled-operations (cited August 2020)."},{"key":"C5","unstructured":"National Hip Fracture Database (NHFD) annual report 2019. https:\/\/www.rcplondon.ac.uk\/projects\/outputs\/national-hip-fracture-database-nhfd-annual-report-2019 (cited June 2020)."},{"key":"C6","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu065"},{"key":"C7","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2017.9.1.10"},{"key":"C8","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2521-4"},{"key":"C9","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-32098-7"},{"key":"C10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2006.03786.x"},{"key":"C11","unstructured":"Office for National Statistics. 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