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Effects of accelerated versus standard care surgery on the risk of acute kidney injury in patients with a hip fracture: a substudy protocol of the hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) international randomised controlled trial

Borges FK 1 , Devereaux PJ 2 , Cuerden M 3 , Bhandari M 4 , Guerra-Farfán E 5 , Patel A 1 Show all authors , Sigamani A 6 , Umer M 7 , Neary J 1 , Tiboni M 1 , Tandon V 1 , Ramokgopa MT 8 , Sancheti P 9 , John B 10 , Lawendy A 11 , Balaguer-Castro M 12 , Jenkinson R 13 , Ślęczka P 14 , Nabi Nur A 15 , Wood GCA 16 , Feibel R 17 , McMahon JS 18 , Sigamani A 19 , Biccard BM 20 , Landoni G 21 , Szczeklik W 22 , Wang CY 23 , Tomas-Hernandez J 5 , Abraham V 10 , Vincent J 2 , Harvey V 2 , Pettit S 2 , Sontrop J 24 , Garg AX 25 , HIP ATTACK investigators

Affiliations 

  • 1 Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • 2 Department of Perioperative Medicine, Population Health Research Institute, Hamilton, Ontario, Canada
  • 3 Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada
  • 4 Department of Surgery, McMaster University, Hamilton, Ontario, Canada
  • 5 Department of Orthopaedic Surgery and Traumatology, University Hospital Vall d'Hebron, Barcelona, Spain
  • 6 Clinical Research, Narayana Hrudayalaya Limited, Bangalore, India
  • 7 Department of Orthopaedic Surgery, Aga Khan University, Karachi, Pakistan
  • 8 Department of Orthopaedic Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
  • 9 Department of Orthopaedic Surgery, Sancheti Institute for Orthopaedics & Rehabilitation, Pune, India
  • 10 Department of Orthopaedic Surgery, Christian Medical College and Hospital Ludhiana, Ludhiana, India
  • 11 Department of Surgery, Western University, London, Ontario, Canada
  • 12 Department of Orthopaedic Surgery and Traumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
  • 13 Department of Surgery and Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  • 14 Orthopaedic Department, SPZOZ, Myslenice, Poland
  • 15 Department of Orthopaedic Surgery, Shifa International Hospital, Islamabad, Pakistan
  • 16 Department of Surgery, Queen's University, Kingston, Ontario, Canada
  • 17 Division of Orthopaedic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
  • 18 Department of Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada
  • 19 Department of Orthopaedic, Government TD Medical College, Allapuzha, India
  • 20 Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Rondebosch, South Africa
  • 21 Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
  • 22 Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
  • 23 Department of Anaesthesiology, University Malaya, Kuala Lumpur, Malaysia
  • 24 Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
  • 25 Departments of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada amit.garg@lhsc.on.ca
BMJ Open, 2019 Sep 24;9(9):e033150.
PMID: 31551393 DOI: 10.1136/bmjopen-2019-033150

Abstract

INTRODUCTION: Inflammation, dehydration, hypotension and bleeding may all contribute to the development of acute kidney injury (AKI). Accelerated surgery after a hip fracture can decrease the exposure time to such contributors and may reduce the risk of AKI.

METHODS AND ANALYSIS: Hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) is a multicentre, international, parallel-group randomised controlled trial (RCT). Patients who suffer a hip fracture are randomly allocated to either accelerated medical assessment and surgical repair with a goal of surgery within 6 hours of diagnosis or standard care where a repair typically occurs 24 to 48 hours after diagnosis. The primary outcome of this substudy is the development of AKI within 7 days of randomisation. We anticipate at least 1998 patients will participate in this substudy.

ETHICS AND DISSEMINATION: We obtained ethics approval for additional serum creatinine recordings in consecutive patients enrolled at 70 participating centres. All patients provide consent before randomisation. We anticipate reporting substudy results by 2021.

TRIAL REGISTRATION NUMBER: NCT02027896; Pre-results.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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