PP065-SUN EFFECT OF NUTRITIONAL INTERVENTION ON LENGTH OF STAY, POSTOPERATIVE COMPLICATIONS, FUNCTIONAL STATUS AND MORTALITY IN HIP FRACTURE PATIENTS: A MULTI-CENTRE RANDOMISED CONTROLLED TRIAL (RCT)

2012 ◽  
Vol 7 (1) ◽  
pp. 51 ◽  
Author(s):  
C.E. Wyers ◽  
P.L. Reijven ◽  
J.J. Breedveld-Peters ◽  
S. van Helden ◽  
M. Schotanus ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Randomised Controlled Trial ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Functional Status ◽  
Controlled Trial ◽  
Nutritional Intervention ◽  
Randomised Controlled

scholarly journals Effects of accelerated versus standard care surgery on the risk of acute kidney injury in patients with a hip fracture: a substudy protocol of the hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) international randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e033150 ◽  
Author(s):  
Flavia K Borges ◽  
P J Devereaux ◽  
Meaghan Cuerden ◽  
Mohit Bhandari ◽  
Ernesto Guerra-Farfán ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Surgical Treatment ◽  
Hip Fracture ◽  
Randomised Controlled Trial ◽  
Standard Care ◽  
Controlled Trial ◽  
Kidney Injury ◽  
Registration Number ◽  
Randomised Controlled ◽  
Care Surgery

IntroductionInflammation, dehydration, hypotension and bleeding may all contribute to the development of acute kidney injury (AKI). Accelerated surgery after a hip fracture can decrease the exposure time to such contributors and may reduce the risk of AKI.Methods and analysisHip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) is a multicentre, international, parallel-group randomised controlled trial (RCT). Patients who suffer a hip fracture are randomly allocated to either accelerated medical assessment and surgical repair with a goal of surgery within 6 hours of diagnosis or standard care where a repair typically occurs 24 to 48 hours after diagnosis. The primary outcome of this substudy is the development of AKI within 7 days of randomisation. We anticipate at least 1998 patients will participate in this substudy.Ethics and disseminationWe obtained ethics approval for additional serum creatinine recordings in consecutive patients enrolled at 70 participating centres. All patients provide consent before randomisation. We anticipate reporting substudy results by 2021.Trial registration numberNCT02027896; Pre-results.

scholarly journals Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial

The Lancet ◽  
2020 ◽  
Vol 395 (10225) ◽  
pp. 698-708 ◽  
Author(s):  
Flavia K Borges ◽  
Mohit Bhandari ◽  
Ernesto Guerra-Farfan ◽  
Ameen Patel ◽  
Alben Sigamani ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Randomised Controlled Trial ◽  
Standard Care ◽  
Controlled Trial ◽  
Randomised Controlled

scholarly journals Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation

Thorax ◽  
2018 ◽  
Vol 73 (8) ◽  
pp. 713-722 ◽  
Author(s):  
Carlos Echevarria ◽  
Joanne Gray ◽  
Tom Hartley ◽  
John Steer ◽  
Jonathan Miller ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Length Of Stay ◽  
Controlled Trial ◽  
Prognostic Score ◽  
Cost Effective ◽  
Low Risk ◽  
Copd Exacerbation ◽  
Hospitalised Patients ◽  
Life Years ◽  
Randomised Controlled

BackgroundPrevious models of Hospital at Home (HAH) for COPD exacerbation (ECOPD) were limited by the lack of a reliable prognostic score to guide patient selection. Approximately 50% of hospitalised patients have a low mortality risk by DECAF, thus are potentially suitable.MethodsIn a non-inferiority randomised controlled trial, 118 patients admitted with a low-risk ECOPD (DECAF 0 or 1) were recruited to HAH or usual care (UC). The primary outcome was health and social costs at 90 days.ResultsMean 90-day costs were £1016 lower in HAH, but the one-sided 95% CI crossed the non-inferiority limit of £150 (CI −2343 to 312). Savings were primarily due to reduced hospital bed days: HAH=1 (IQR 1–7), UC=5 (IQR 2–12) (P=0.001). Length of stay during the index admission in UC was only 3 days, which was 2 days shorter than expected. Based on quality-adjusted life years, the probability of HAH being cost-effective was 90%. There was one death within 90 days in each arm, readmission rates were similar and 90% of patients preferred HAH for subsequent ECOPD.ConclusionHAH selected by low-risk DECAF score was safe, clinically effective, cost-effective, and preferred by most patients. Compared with earlier models, selection is simpler and approximately twice as many patients are eligible. The introduction of DECAF was associated with a fall in UC length of stay without adverse outcome, supporting use of DECAF to direct early discharge.Trial registration numberRegistered prospectively ISRCTN29082260.

scholarly journals Rationale and design of the HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) Trial: a protocol for an international randomised controlled trial evaluating early surgery for hip fracture patients

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e028537 ◽  
Author(s):  
Flavia K Borges ◽  
Mohit Bhandari ◽  
Ameen Patel ◽  
Victoria Avram ◽  
Ernesto Guerra-Farfán ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Randomised Controlled Trial ◽  
Standard Care ◽  
Perioperative Complications ◽  
Public Awareness ◽  
Controlled Trial ◽  
Early Surgery ◽  
All Cause Mortality ◽  
Randomised Controlled

IntroductionAnnually, 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 analysisHIP 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 disseminationAll 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 numberNCT02027896; Pre-results.

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