Work

Impact of SARS-CoV-2 subvariants on postoperative outcomes in geriatric hip fracture patients – a multinational multicentre study

Year: 2025

Type: article

Abstract: BACKGROUND: Hip fractures (HF) are among the most prevalent diagnoses in geriatric traumatology, with persistently high incidence even during the COVID-19 pandemic. Concomitant SARS-CoV-2 infection adds clinical complexity and has been associated with increased mortality and prolonged hospitalisation. This study aimed to assess the impact of SARS-CoV-2 subvariants B.1.1.7 (Alpha), B.1.617.2 (Delta), and B.1.1.529 (Omicron) on postoperative outcomes in patients undergoing surgical treatment for HF. METHODS: ) between March 2021 and April 2022 across 119 hospitals. 12,707 patients undergoing HF surgery were included and stratified by predominant subvariant periods: Alpha (n = 3714), Delta (n = 5434), and Omicron (n = 3559). Each cohort was further stratified by SARS-CoV-2 status at admission. RESULTS: During the Alpha period, in-hospital mortality and length of stay were similar between COVID-19-comorbid (8.3%, 13 days) and SARS-CoV-2-negative patients (5.4%, 15 days). In the Delta and Omicron periods, mortality was significantly higher among COVID-19-comorbid patients (14.3% and 13.9%) compared to SARS-CoV-2-negative patients (5.8%, p = 0.017; 5.7%, p < 0.001), with longer hospitalisations (17 vs. 15 days, p < 0.05). COVID-19-comorbid patients were more frequently institutionalised and exhibited lower levels of pre-fracture mobility compared to SARS-CoV-2-negative patients. CONCLUSION: COVID-19-positive patients showed lower mortality during the Alpha period and higher mortality during the Delta and Omicron periods. Overall, COVID-19 comorbidity was associated with increased in-hospital mortality and longer hospitalisation. These observations may be influenced by unmeasured confounding. TRIAL REGISTRATION: ) and was approved by the ethics committee of the University of Muenster (reference number: 2022-268-f-S). This study was conducted in accordance with the Declaration of Helsinki.

Source: BMC Geriatrics

DOI: 10.1186/s12877-025-06840-6

Authors: Gregor Toporowski, Christian M. Mueller-Mai, Katherine Rascher, Jonas Wiedemann

Institutions: University Hospital Münster, University of Münster, Katholisches Klinikum Lünen/Werne , St.-Marien-Hospital Lünen

Language: English

Topic: Hip and Femur Fractures

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190