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Do inflammatory molecules predict prognosis in patients with hip fracture and COVID-19? Can deferring surgery improve outcome and prognosis?

Traumatology service -  Drs. Noriego, D., Hernández, A., Dellonder, J., Servitja, R.,  Silva, D. and García, J.
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About the project

Pilot study to examine the prognostic value of inflammatory parameters in patients with waist fracture and COVID-19.


Summary of the idea:

To carry out an analysis of conventional and specific inflammatory markers in patients who associate a malunion fracture with a COVID infection. The objective is to determine which of these patients, who usually require early surgery for malunion fracture, have a poorer prognosis at the time of admission. This fact leads to a poor evolution of the patient, who may require mechanical ventilation, admission to the ICU or even death. In this sense, the question is whether postponing surgery until the clinical improvement of the active infection by COVID improves the outcome and prognosis of these patients who are already susceptible to clinical improvement after undergoing surgery for their associated pathology.


Objectives, impact and proposed solution:

Our hypothesis is that inflammatory markers may be associated with increased mortality in patients with malunion fracture and COVID-19.

Specifically, the main objective is to examine the prognostic value of inflammatory parameters in patients with malunion fracture and a confirmed diagnosis of COVID. Secondary objectives include: the study of the behaviour of inflammatory markers in the different groups of patients at baseline, the identification of patients with an inflammatory hyperresponse caused by COVID infection, to determine the rate of complications and analyse what type they are, and finally, to monitor the evolution of the results (mortality, ICU admission, need for mechanical ventilation).

If the expected results confirming the existence of a relationship between some inflammatory markers and the prognosis of the patient with COVID-confirmed infection are obtained, it is possible to diagnose the patient and start a treatment consisting of the introduction of anti-inflammatory medication directed from the moment of admission to achieve a systemic improvement that allows early surgery or even defer the moment of surgical treatment so as not to worsen the patient's condition and therefore lead to a bad evolution.