HIP ATTACK
Research type
Research Study
Full title
HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) Trial
IRAS ID
148493
Contact name
Philip J Devereaux
Contact email
Sponsor organisation
Population Health Research Institute
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Research Summary:
A hip fracture is a common injury in the elderly with approximately 3 million occurring annually around the world (70,000 in the UK). The incidence is increasing as the population ages. 30 day mortality from this condition is about 6-10%.
A hip fracture initiates a number of stress responses that can cause medical complications. Evidence suggests early surgical treatment of a hip fracture may improve patients’ outcomes; however, standard care is that most patients typically wait >24 hours to have surgery. We propose to undertake a large international randomized controlled trial (RCT) to assess the impact of accelerated medical clearance and surgery versus standard care of hip fractures. We call this trial the HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) Trial.
A published pilot trial for this study involving 60 participants found a major peri-operative complication occurred in 9 (30%) of the patients in the accelerated care group and 14 (47%) of the patients in the standard care group (hazard ratio 0.60, 95% confidence interval 0.26–1.39). There were four deaths within 30 days in the standard group versus one in the accelerated care group. This study is follow-on from this pilot study to see if this change in treatment for this group of patients can achieve this potentially major benefit.
Reference: The Hip Fracture Accelerated Surgical Treatment and Care Track (HIP ATTACK) Investigators. Accelerated care versus standard care among patients with hip fracture: the HIP ATTACK pilot trial. CMAJ 2013; CMAJ 2013. DOI:10.1503 /cmaj.130901
Summary of Results:
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. Accelerated surgery compared with standard care resulted in a lower risk of delirium, urinary tract infection, and moderate-to severe pain on days 4–7 after randomisation. Accelerated surgery also resulted in faster mobilisation after randomisation and a shorter time from randomisation to hospital discharge.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
17/YH/0006
Date of REC Opinion
23 Feb 2017
REC opinion
Further Information Favourable Opinion