Purpose

The HIP ATTACK-2 trial is a multicentre, international, parallel group randomized controlled trial to determine whether accelerated surgery for hip fracture in patients with acute myocardial injury is superior to standard care in reducing death at 90 days after randomization. The trial will also assess secondary outcomes at 90 days after randomization: inability to independently walk 3 metres, time to first mobilization (first standing and first full weight bear), composite and individual assessment of major complications (e.g., mortality, non-fatal myocardial infarction, acute congestive heart failure, and stroke), delirium, length of stay, pain, and quality of life.

Conditions

Eligibility

Eligible Ages
Over 45 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. age ≥45 years; 2. diagnosis of hip fracture during working hours with a low-energy mechanism requiring surgery; 3. troponin elevation on hospital arrival (at least one troponin level from hip fracture occurrence to randomization above the upper limit of normal); and 4. written informed consent.

Exclusion Criteria

  1. taking a therapeutic dose of an anticoagulant for which no reversing agent is available; 2. patients on a therapeutic vitamin K antagonist with a history of heparin induced thrombocytopenia (HIT); 3. patients with peri-prosthetic fracture, open fracture or bilateral fractures; 4. patients requiring an emergency surgery for another reason (e.g., subdural hematoma); 5. patients with acute myocardial infarction with a mechanical complication (i.e., acute papillary muscle rupture, ventricular septal defect), ST elevation myocardial infarction, or cardiogenic shock; 6. patients refusing consent; or 7. patients previously enrolled in HIP ATTACK-2.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Single (Outcomes Assessor)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Accelerated medical clearance and surgery
Accelerated medical clearance and targeted arrival to the operating room within 6 hours of diagnosis of a hip fracture requiring surgical repair.
  • Other: Accelerated medical clearance and surgery
    Rapid medical clearance with targeted arrival to the operating room within 6 hours of diagnosis of a hip fracture requiring surgical repair.
No Intervention
Standard surgical care
Hip fracture repair and surgical care according to treating institution guidelines.

Recruiting Locations

University of Maryland
Baltimore, Maryland 20742
Contact:
Heather Phipps
HPhipps@som.umaryland.edu

More Details

Status
Recruiting
Sponsor
Population Health Research Institute

Study Contact

Valerie Harvey
905-297-3479
valerie.harvey@phri.ca

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.