Rationale and design of the hip fracture accelerated surgical treatment and care track (hip attack) trial

Introduction Annually, millions of adults suffer hip fractures. The mortality rate post a hip fracture is 7%-10% at 30 days and 10%-20% at 90 days. Observational data suggest that early surgery can improve these outcomes in hip fracture patients. We designed a clinical trial - HIP fracture Accelerat...

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Autores: Kessler Borges, Flavia|||0000-0001-5377-7612, Bhandari, Mohit|||0000-0003-3556-9179, Patel, Ameen|||0000-0002-9338-2815, Avram, Victoria, Guerra-Farfán, Ernesto|||0000-0001-5445-1331, Sigamani, Alben|||0000-0002-6927-1947, Umer, Masood|||0000-0002-8884-9919, Tiboni, Maria, Adili, Anthony, Neary, John, Tandon, Vikas, Sancheti, Parag K.|||0000-0002-8903-1430, Lawendy, AbdelRahman, Jenkinson, Richard, Ramokgopa, Mmampapatla, Biccard, Bruce M.|||0000-0001-5872-8369, Szczeklik, Wojciech|||0000-0002-1349-1123, Wang, Chew Yin|||0000-0002-9066-3830, Landoni, Giovanni|||0000-0002-8594-5980, Forget, Patrice, Popova, Ekaterine|||0000-0002-8781-9873, Wood, Gavin, Nabi Nur, Aamer, John, Bobby, Ślȩczka, Pawel|||0000-0002-0440-688X, Feibel, Robert J., Balaguer Castro, Mariano|||0000-0003-3625-6887, Deheshi, Benjamin, Winemaker, Mitchell, De Beer, Justin, Kolesar, Richard, Teixidor Serra, Jordi|||0000-0003-1280-9088, Tomas-Hernandez, Jordi|||0000-0002-7424-1750, McGillion, Michael, Shanthanna, Harsha, Moppett, Iain, Vincent, Jessica|||0000-0002-2356-8876, Pettit, Shirley, Harvey, Valerie|||0000-0002-3075-4036, Gauthier, Leslie, Alvarado, Kim, Devereaux, P. J.|||0000-0003-2935-637X
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:285059
Acceso en línea:https://ddd.uab.cat/record/285059
https://dx.doi.org/urn:doi:10.1136/bmjopen-2018-028537
Access Level:acceso abierto
Palabra clave:Accelerated surgery
Hip fracture
Randomised control trial
Descripción
Sumario:Introduction Annually, millions of adults suffer hip fractures. The mortality rate post a hip fracture is 7%-10% at 30 days and 10%-20% at 90 days. Observational data suggest that early surgery can improve these outcomes in hip fracture patients. We designed a clinical trial - HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) to determine the effect of accelerated surgery compared with standard care on the 90-day risk of all-cause mortality and major perioperative complications. Methods and analysis HIP ATTACK is a multicentre, international, parallel group randomised controlled trial (RCT) that will include patients ≥45 years of age and diagnosed with a hip fracture from a low-energy mechanism requiring surgery. Patients are randomised to accelerated medical assessment and surgical repair (goal within 6 h) or standard care. The co-primary outcomes are (1) all-cause mortality and (2) a composite of major perioperative complications (ie, mortality and non-fatal myocardial infarction, pulmonary embolism, pneumonia, sepsis, stroke, and life-threatening and major bleeding) at 90 days after randomisation. All patients will be followed up for a period of 1 year. We will enrol 3000 patients. Ethics and dissemination All centres had ethics approval before randomising patients. Written informed consent is required for all patients before randomisation. HIP ATTACK is the first large international trial designed to examine whether accelerated surgery can improve outcomes in patients with a hip fracture. The dissemination plan includes publishing the results in a policy-influencing journal, conference presentations, engagement of influential medical organisations, and providing public awareness through multimedia resources. Trial registration number NCT02027896; Pre-results.

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