Hip fracture hospitalizations down 11% during first COVID-19 lockdown – Healio

October 13, 2021

2 min read


Paccou J, et al. Abstract 1026. Presented at: ASBMR Annual Meeting; Oct. 1-4, 2021; San Diego (hybrid meeting).

Disclosures: Paccou reports no relevant financial disclosures.

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Hip fracture hospitalizations decreased by 11% in France during the first COVID-19 lockdown compared with the year before, according to a speaker at the American Society for Bone and Mineral Research Annual Meeting.

Julien Paccou

“The findings suggest that the first nationwide COVID-19 lockdown in France was associated with a decrease in absolute number of hip fractures,” Julien Paccou, MD, PhD, professor of rheumatology at Lille University Hospital in France, told Healio. “A possible explanation is that the lack of outdoor activity during the first nationwide lockdown led to lower fall rates. As many falls occur outdoors during normal day-to-day activities, the ‘stay-at-home’ strategy could have resulted in a lower number of hip fractures.”

Private, for-profit hospitals in France had an increase in hip fracture hospitalizations during the first COVID-19 lockdown, while public university hospitals and public general hospitals had decreases in hospitalizations. Data were derived from Paccou J, et al. Abstract 1026. Presented at: ASBMR Annual Meeting; Oct. 1-4, 2021; San Diego (hybrid meeting).

Researchers conducted a retrospective study of hospitalizations for hip fractures with French National Hospitals Database information from Jan. 1, 2020, to July 31, 2020. The pre-lockdown period was defined as January 1 to March 15, 2020, the COVID-19 lockdown from March 16 to May 10, 2020, and post-lockdown from May 11 to July 31, 2020. Hospitalization rate ratios (HRR) were compared for all three periods with the same time period in 2019. Only hip fractures among adults aged 50 years and older were included. Secondary outcomes included HRRs stratified by sex, age and hospital type.

During lockdown, 10,429 adults were hospitalized with hip fractures, a decrease from 11,782 during the same period in 2019 (HRR = 0.89; 95% CI, 0.86-0.91; P < .001). The decrease in hip fracture hospitalizations was observed among men and women. No significant change in the number of hip fracture hospitalizations was observed before or after lockdown.

A decrease in hip fracture hospitalizations was observed for all age groups except for adults aged 90 years and older, with HRRs increasing as age increased.

Hospitalizations fell about 33% for public university hospitals and 24% for public general hospitals during the lockdown, but private for-profit hospitals had an increase of 46%.

“We showed that the first nationwide COVID-19 lockdown in France had a differential impact on hip fractures depending on hospital type,” Paccou said during a presentation. “The overburdening of the public health care system by COVID-19 patients may explain these findings.”

Paccou said the long-term impact of COVID-19 on fracture incidences and osteoporosis care will need to be studied further in the coming years.

“Firstly, to assess the number of other fractures, especially other major osteoporotic fractures,” Paccou told Healio. “Secondly, to collect full-year data for 2020. Lastly, to obtain data on where the hip fractures actually occurred [indoors or outdoors].”