Sarasota, FL (WorkersCompensation.com) – Providers in Italy are adding thoracic x-rays to their protocol for COVID-19 patients after a study recently published in the Journal of Clinical Endocrinology and Metabolism shows a correlation between spinal fractures and increased death rates.
The study reviewed records of 114 patients at San Raffaele Hospital in Italy. Ninety patients – 78.9 percent – were hospitalized after an initial evaluation was done. Of those that were admitted, 13 patients were transferred to ICUs, and 16 patients – 14.5 percent – died.
Upon admission, clinicians determined that 41 patients had spinal fractures. After admission, in the course of care, it was determined that an additional 24 patients also had spinal fractures. Of the total 65 cases with spinal fractures, 60 percent were classified as mild, 33.3 percent as moderate, and 7.7 percent as severe.
Hospitalization was required for 88 percent of the fracture group patients, compared to 74 percent of the non-fracture patients. The patients with fractures were generally older with a tendency of hypertension and coronary artery disease. Additionally, they required more respiratory ventilation care than those without factures. The mortality rate for the group of patients with spinal fractures was 22 percent, compared to 10 percent for those patients with no spinal fractures. When broken out by severity of fractures, the mortality rate was higher for severe spinal fracture patients than for moderate or mild fractures.
The study goes on to say that spinal fractures may be an indicator of cardiorespiratory risk and prognosis of COVID-19 patients.
According to a new report from healthcare data ranking company Healthgrades, hospital ranking could be an indicator of prognosis as well. The Healthgrades report ranked performance of nearly 4,500 hospitals across the U.S. based on mortality and complication rates of 32 most common procedures. The report found that patients with hypertension were 1.9 to 2.3 times more likely to experience a complication during a joint replacement, and 1.5 to 2.0 times more likely to have complications during spinal surgery than those without hypertension. Those patients with coronary artery disease had a 35.7 percent to 40.7 percent higher risk of complications during a joint replacement.
Additionally, complication and mortality rates decreased in facilities with a higher ranking. For instance, according to the report, patients treated for heart failure and COPD at a 5 star hospital had a 60.5 to 83.3 percent lower chance of dying than if they were treated at a lower ranked hospital. Patients with community acquired pneumonia had a 74.1 percent lower risk of dying if they were treated in a 5 star facility instead of a 1 star facility. Patients treated at a 1 star facility for respiratory failure were 2 times as likely to die than if they were treated at a 5 star facility.