Coronavirus infection in hip fractures (CHIP) study

Area of Science:

• Orthopedics
• Infectious Diseases
• Gerontology

Background:

• Hip fracture incidence remained stable during the COVID-19 pandemic.
• COVID-19 infection is associated with increased mortality.
• Outcomes for COVID-19 negative hip fracture patients during the pandemic are not well understood.
• The role of vitamin D in COVID-19 hip fracture patient mortality requires investigation.

Purpose of the Study:

• To compare mortality outcomes in COVID-19 positive versus COVID-19 negative hip fracture patients during the pandemic.
• To investigate the association between vitamin D levels and mortality in hip fracture patients, particularly those with COVID-19.

Main Methods:

• A multicentre observational study involving 1,633 hip fracture patients across nine hospital trusts in North West England.
• Data collected for three months in March 2020 (pandemic) and March 2019 (pre-pandemic).
• Patients were matched by Nottingham Hip Fracture Score (NHFS), hospital, and fracture type.
• Analysis focused on 30-day mortality rates and the impact of vitamin D levels.

Main Results:

• Demographics were similar between 2019 and 2020 groups, with a slight increase in male patients in 2020.
• Thirty-day mortality was significantly higher in COVID-19 positive patients (35.6%) compared to COVID-19 negative patients (7.8%).
• A potential association between decreasing vitamin D levels and increasing mortality in COVID-19 positive patients was observed, but did not reach statistical significance.

Conclusions:

• COVID-19 positive hip fracture patients experienced a significant increase in 30-day mortality during 2020.
• COVID-19 negative hip fracture patients did not show a significant increase in 30-day mortality.
• Low vitamin D levels may be associated with higher mortality rates in COVID-19 positive hip fracture patients.