header advert
You currently have no access to view or download this content. Please log in with your institutional or personal account if you should have access to through either of these
The Bone & Joint Journal Logo

Receive monthly Table of Contents alerts from The Bone & Joint Journal

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Get Access locked padlock


Coronavirus in hip fractures (CHIP) 4

has vaccination improved mortality outcomes in hip fracture patients?

Download PDF



Prior to the availability of vaccines, mortality for hip fracture patients with concomitant COVID-19 infection was three times higher than pre-pandemic rates. The primary aim of this study was to determine the 30-day mortality rate of hip fracture patients in the post-vaccine era.


A multicentre observational study was carried out at 19 NHS Trusts in England. The study period for the data collection was 1 February 2021 until 28 February 2022, with mortality tracing until 28 March 2022. Data collection included demographic details, data points to calculate the Nottingham Hip Fracture Score, COVID-19 status, 30-day mortality, and vaccination status.


A total of 337 patients tested positive for COVID-19. The overall 30-day mortality in these patients was 7.7%: 5.5% in vaccinated patients and 21.7% in unvaccinated patients. There was no significant difference between post-vaccine mortality compared with pre-pandemic 2019 controls (7.7% vs 5.0%; p = 0.068). Independent risk factors for mortality included unvaccinated status, Abbreviated Mental Test Score ≤ 6, male sex, age > 80 years, and time to theatre > 36 hours, in decreasing order of effect size.


The vaccination programme has reduced 30-day mortality rates in hip fracture patients with concomitant COVID-19 infection to a level similar to pre-pandemic. Mortality for unvaccinated patients remained high.

Cite this article: Bone Joint J 2022;104-B(12):1362–1368.

Correspondence should be sent to Fatima Rashid. E-mail:

CHIP collaborative group: The primary authors would like to thank the CHIP collaborative group; Muyed Mohamed, Farrukh Gillani (Raigmore Hospital); Graeme Wilson, James McEvoy (Warrington Hospital); Rahul Mohan, David Samy (Arrowe Park Hospital); Abhishek Arora (Doncaster Royal Infirmary); Anil Singh Dhadwal, Nikita Patel (St Helens and Knowsley Teaching Hospital NHS Trust); Jason Jia Shyan Ong (Sherwood Forrest Hospitals NHS Foundation Trust); Hafiz M Umer, Arjun Paramsivan (The Countess of Chester Hospital); Aleksandra Adamczyk, John Edwin (Mid and South Essex NHS Foundation Trust); Ross McAllister (Leighton Hospital); Sanket Dilip Gandhi, Ala’a Abusido (Stoke Mandeville Hospital); Muhammad Amer Bashir, Emily Armstrong (North Middlesex University Hospital); Neville Mamoowala, Henry Crouch-Smith, Mohammed Khattak, Harry Benjamin-Laing (Liverpool University Hospitals Foundation Trust); Talha Azam Tarrar, Atiba Akii Bua (Queens Medical Centre, Nottingham University Hospital); Rana Tahoun, Xue Ning Lee (Royal Blackburn Hospital); Turab Arshad Syed, Mohamed Nafea (Forth Valley Royal Hospital, Scotland); Wasim Sardar Khan, Aniket Bharadwaj, Stewart Tsui (Addenbrooke’s Hospital, Cambridge); Imran A Ali, Hussam Elbana (Lancaster Royal Infirmary); Ahmed Hagnasir, Umair Ahmad, Zawar Ahmad, (Birmingham Heartlands Hospital); Brian Hanratty, Bakhat Yawar (Altnagelvin Area Hospital).

For access options please click here