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Fast-tracked surgery for hip fracture does not reduce mortality

Key clinical point: Accelerated surgery after hip fracture does not improve mortality or reduce major complications, can hasten mobilization, weight-bearing, and hospital discharge, and reduce the risk of urinary tract infection and delirium.

Major finding: At 90 days, 9% of patients in the accelerated-surgery group and 10% of those in the usual-care group had died, a nonsignificant difference. In both groups, 22% of patients experienced a major complication.

Study details: Prospective, randomized, international trial of 2,970 patients, aged 45 years and older, who sustained a low-energy hip fracture requiring surgical repair.

Disclosures: Multiple HIP ATTACK coinvestigators reported relationships with pharmaceutical and medical device companies, including companies that manufacture hip prosthesis and orthopedic surgical devices and implants. The study was sponsored by the Canadian Population Health Research Institute, the Ontario Strategy for Patient Oriented Research Support Unit, the Ontario Ministry of Health and Long-Term Care, the Hamilton Health Sciences Foundation, Physicians’ Services Incorporated Foundation, Michael G. DeGroote Institute for Pain Research and Care, Smith & Nephew (to recruit patients in Spain), and Indiegogo Crowdfunding.

Citation:

Borges F et al. Lancet. 2020 Feb. 9. doi: 10.1016/S0140-6736(20)30058-1.