Among older individuals, hip fracture surgery volumes were generally lower during the COVID-19 pandemic than two years earlier until the COVID-19 vaccine became available, according to a research letter published online Dec. 30 in the Journal of the American Medical Association.

Kanu Okike, M.D., M.P.H., from Kaiser Permanente in Honolulu, and colleagues examined hip fracture surgery volumes among individuals ages 65 years or older during the pandemic. The incidence rate was calculated for each of eight phases during the pandemic (presurge [Jan. 1 to March 15, 2020], spring 2020 surge [March 16 to May 10], early summer 2020 surge [May 11 to June 28], summer 2020 surge [June 29 to Aug. 23], fall 2020 surge [Aug. 24 to Nov. 22], winter surge [Nov. 23, 2020, to Feb. 21, 2021], early vaccination period [Feb. 22 to July 18, 2021], and delta wave [July 19 to Sept. 26, 2021]) and were compared to the historical period two years prior.

The researchers found that during the presurge period, the volume of hip fracture surgery was similar to that of the historical period, but was lower in the spring 2020 surge (incidence rate ratio, 0.81; 95 percent confidence interval, 0.73 to 0.90; P < 0.001). Apart from the fall 2020 period, the volumes of hip fracture surgery were lower relative to the historical period until the early vaccination period (incidence rate ratio, 0.96; 95 percent confidence interval, 0.90 to 1.02; P = 0.18) and the delta wave.

"Further research should determine how volume patterns evolve with increasing vaccinations and COVID-19 variants and investigate the reasons for the lower incidence, which may provide insight into ways to decrease hip fractures among older individuals," the authors write.