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L. and Millan, Angelica and Banos, Victoria and Herrera-Mateo, Sergio and Aguado, Hector J. and Martinez-Municio, Gonzalo and Leon, Ricardo and Santiago-Maniega, Silvia and Zabalza, Ana and Labrador, Gregorio and Guerado, Enrique and Cruz, Encarnacion and Cano, Juan Ramon and Bogallo, Jose Manuel and Sa-Ngasoongsong, Paphon and Kulachote, Noratep and Sirisreetreerux, Norachart and Pengrung, Nachapan and Chalacheewa, Theerawat and Arnuntasupakul, Vanlapa and Yingchoncharoen, Teerapat and Naratreekoon, Bundit and Kadry, Miriam Adel and Thayaparan, Surendini and Abdlaziz, Ihab and Aframian, Arash and Imbuldeniya, Arjuna and Bentoumi, Souad and Omran, Sherif and Vizcaychipi, Marcela Paola and Correia, Patricia and Patil, Shashank and Haire, Kevin and Mayor, Amy S. E. and Dillingham, Sally and Nicholson, Laura and Elnaggar, Mohamed and John, Joby and Nanjayan, Shashi Kumar and Parker, Martyn J. and O'Sullivan, Susan and Marmor, Meir T. and Matityahu, Amir and McClellan, Robert Trigg and Comstock, Curt and Ding, Anthony and Toogood, Paul and Slobogean, Gerard and Joseph, Katherine and O'Toole, Robert and Sciadini, Marcus and Ryan, Scott P. and Clark, Molly E. and Cassidy, Charles and Balonov, Konstantin and Bergese, Sergio D. and Phieffer, Laura S. and Zacarias, Alicia A. Gonzalez and Marcantonio, Andrew J. and Dragic-Taylor, Sanela and Maxwell, Chelsea and Molnar, Sarah and Wells, Jennifer R. and Ofori, Sandra N. and Yang, Stephen S. and Wang, Michael K. and Duceppe, Emmanuelle and Spence, Jessica and Vasquez, Javiera P. and Marcano-Fernandez, Francesc and Ham, Hyungjoo and Prada, Carlos and Yung, Terence C. H. and Perez, Isidro Sanz and Bosch, Michael J. and Prystajecky, Michael R. and Chowdhury, Chinmoy and Khan, James S. and Stella, Steffan F. and Heidary, Behrouz and Tran, Allen and Wawrzycka-Adamczyk, Katarzyna and Chen, Yu Chiao Peter and Gonzalez-Osuna, Aranzazu and Biedron, Grzegorz and Wludarczyk, Anna and Lefebvre, Marco and Ernst, Jaclyn A. and Staffhorst, Bas and Woodfine, Jason D. and Alwafi, Emad M. and Mrkobrada, Marko and Parlow, Simon and Roberts, Robin and McAlister, Finlay and Sackett, David and Wright, James and Investigators, HIP ATTACK (2020) Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial. Lancet, 395 (10225). pp. 698-708. ISSN 0140-6736, DOI https://doi.org/10.1016/S0140-6736(20)30058-1.
Full text not available from this repository.Abstract
Background Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4-9) in the accelerated-surgery group and 24 h (10-42) in the standard-care group (p<0.0001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0.91 (95% CI 0.72 to 1.14) and absolute risk reduction (ARR) of 1% (-1 to 3; 1:0.40). Major complications occurred in 321 (22%) patients assigned to accelerated surgery and 331 (22%) assigned to standard care, with an HR of 0.97 (0.83 to 1.13) and an ARR of 1% (-2 to 4; p=0.71). Interpretation Among patients with a hip fracture, accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care. Copyright (C) 2020 Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | MORTALITY; PATIENT MANAGEMENT; OUTCOME; SASPIRIN; 30-DAY; TIME; NECK |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine |
| Divisions: | Faculty of Medicine > Anaesthesiology Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 27 Feb 2024 03:31 |
| Last Modified: | 27 Feb 2024 03:35 |
| URI: | http://eprints.um.edu.my/id/eprint/37865 |
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