Borges, Flavia K. and Guerra-Farfan, Ernesto and Bhandari, Mohit and Patel, Ameen and Slobogean, Gerard and Feibel, Robert J. and Sancheti, Parag K. and Tiboni, Maria E. and Balaguer-Castro, Mariano and Tandon, Vikas and Tomas-Hernandez, Jordi and Sigamani, Alben and Sigamani, Alen and Szczeklik, Wojciech and Mcmahon, Stephen J. and Sleczka, Pawel and Ramokgopa, Mmampapatla T. and Adinaryanan, S. and Umer, Masood and Jenkinson, Richard J. and Lawendy, Abdel and Popova, Ekaterine and Nur, Aamer Nabi and Wang, Chew Yin and Vizcaychipi, Marcela and Biccard, Bruce M. and Ofori, Sandra and Spence, Jessica and Duceppe, Emmanuelle and Marcucci, Maura and Harvey, Valerie and Balasubramanian, Kumar and Vincent, Jessica and Tonelli, Ana Claudia and Devereaux, P. J. and Investigators, HIP ATTACK (2024) Myocardial Injury in Patients with Hip Fracture A HIP ATTACK Randomized Trial Substudy. Journal of Bone and Joint Surgery-American Volume, 106 (24). pp. 2303-2312. ISSN 0021-9355, DOI https://doi.org/10.2106/JBJS.23.01459.
Full text not available from this repository.Abstract
Background: Myocardial injury after a hip fracture is common and has a poor prognosis. Patients with a hip fracture and myocardial injury may benefit from accelerated surgery to remove the physiological stress associated with the hip fracture. This study aimed to determine if accelerated surgery is superior to standard care in terms of the 90-day risk of death in patients with a hip fracture who presented with an elevated cardiac biomarker/enzyme measurement at hospital arrival. Methods: The HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) trial was a randomized controlled trial designed to determine whether accelerated surgery for hip fracture was superior to standard care in reducing death or major complications. This substudy is a post-hoc analysis of 1392 patients (from the original study of 2970 patients) who had a cardiac biomarker/enzyme measurement (>99.9% had a troponin measurement and thus ``troponin'' is the term used throughout the paper) at hospital arrival. The primary outcome was all-cause mortality. The secondary composite outcome included all-cause mortality and non-fatal myocardial infarction, stroke, and congestive heart failure 90 days after randomization. Results: Three hundred and twenty-two (23%) of the 1392 patients had troponin elevation at hospital arrival. Among the patients with troponin elevation, the median time from hip fracture diagnosis to surgery was 6 hours (interquartile range IQR] = 5 to 13) in the accelerated surgery group and 29 hours (IQR = 19 to 52) in the standard care group. Patients with troponin elevation had a lower risk of mortality with accelerated surgery compared with standard care (17 10%] of 163 versus 36 23%] of 159; hazard ratio HR] = 0.43 95% confidence interval (CI) = 0.24 to 0.77]) and a lower risk of the secondary composite outcome (23 14%] of 163 versus 47 30%] of 159; HR = 0.43 95% CI = 0.26 to 0.72]). Conclusions: One in 5 patients with a hip fracture presented with myocardial injury. Accelerated surgery resulted in a lower mortality risk than standard care for these patients; however, these findings need to be confirmed.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RD Surgery |
| Divisions: | Faculty of Medicine > Anaesthesiology Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 17 Mar 2025 03:45 |
| Last Modified: | 17 Mar 2025 03:45 |
| URI: | http://eprints.um.edu.my/id/eprint/47244 |
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