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

Flavia K Borges; P J Devereaux; Meaghan Cuerden; Mohit Bhandari; Ernesto Guerra-Farfán; Ameen Patel; Alben Sigamani; Masood Umer; John Neary; Maria Tiboni; Vikas Tandon; Mmampapatla Thomas Ramokgopa; Parag Sancheti; Bobby John; AbdelRahman Lawendy; Mariano Balaguer-Castro; Richard Jenkinson; Paweł Ślęczka; Aamer Nabi Nur; Gavin C A Wood; Robert Feibel; John Stephen McMahon; Alen Sigamani; Bruce M Biccard; Giovanni Landoni; Wojciech Szczeklik; Chew Yin Wang; Jordi Tomas-Hernandez; Valsa Abraham; Jessica Vincent; Valerie Harvey; Shirley Pettit; Jessica Sontrop; Amit X Garg; HIP ATTACK investigators

doi:10.1136/bmjopen-2019-033150

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

BMJ Open. 2019 Sep 24;9(9):e033150. doi: 10.1136/bmjopen-2019-033150.

Authors

Flavia K Borges^{1

2}, P J Devereaux^{2

3}, Meaghan Cuerden⁴, Mohit Bhandari⁵, Ernesto Guerra-Farfán⁶, Ameen Patel¹, Alben Sigamani⁷, Masood Umer⁸, John Neary¹, Maria Tiboni¹, Vikas Tandon¹, Mmampapatla Thomas Ramokgopa^{9

10}, Parag Sancheti¹¹, Bobby John¹², AbdelRahman Lawendy¹³, Mariano Balaguer-Castro¹⁴, Richard Jenkinson^{15

16}, Paweł Ślęczka¹⁷, Aamer Nabi Nur¹⁸, Gavin C A Wood¹⁹, Robert Feibel²⁰, John Stephen McMahon²¹, Alen Sigamani²², Bruce M Biccard²³, Giovanni Landoni^{24

25}, Wojciech Szczeklik²⁶, Chew Yin Wang²⁷, Jordi Tomas-Hernandez⁶, Valsa Abraham¹², Jessica Vincent², Valerie Harvey², Shirley Pettit², Jessica Sontrop²⁸, Amit X Garg^{29

4

28}; 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 Departments of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.
⁴ Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.
⁵ Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
⁶ Department of Orthopaedic Surgery and Traumatology, University Hospital Vall d'Hebron, Barcelona, Spain.
⁷ Clinical Research, Narayana Hrudayalaya Limited, Bangalore, India.
⁸ Department of Orthopaedic Surgery, Aga Khan University, Karachi, Pakistan.
⁹ Department of Orthopaedic Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
¹⁰ Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa.
¹¹ Department of Orthopaedic Surgery, Sancheti Institute for Orthopaedics & Rehabilitation, Pune, India.
¹² Department of Orthopaedic Surgery, Christian Medical College and Hospital Ludhiana, Ludhiana, India.
¹³ Department of Surgery, Western University, London, Ontario, Canada.
¹⁴ Department of Orthopaedic Surgery and Traumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
¹⁵ Department of Surgery and Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
¹⁶ Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
¹⁷ Orthopaedic Department, SPZOZ, Myslenice, Poland.
¹⁸ Department of Orthopaedic Surgery, Shifa International Hospital, Islamabad, Pakistan.
¹⁹ Department of Surgery, Queen's University, Kingston, Ontario, Canada.
²⁰ Division of Orthopaedic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
²¹ Department of Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada.
²² Department of Orthopaedic, Government TD Medical College, Allapuzha, India.
²³ Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Rondebosch, South Africa.
²⁴ Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
²⁵ Department of Anaesthesia and Intensive Care, Vita-Salute San Raffaele University, Milan, Italy.
²⁶ Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.
²⁷ Department of Anaesthesiology, University Malaya, Kuala Lumpur, Malaysia.
²⁸ Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
²⁹ Departments of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada amit.garg@lhsc.on.ca.

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.

Keywords: accelerated surgery; acute kidney injury; hip fracture.

Publication types

Clinical Trial Protocol
Research Support, Non-U.S. Gov't

MeSH terms

Acute Kidney Injury* / etiology
Acute Kidney Injury* / prevention & control
Adult
Female
Fracture Fixation* / adverse effects
Fracture Fixation* / methods
Hip Fractures* / diagnosis
Hip Fractures* / physiopathology
Hip Fractures* / surgery
Humans
Male
Multicenter Studies as Topic
Patient Care Planning / standards
Postoperative Complications* / prevention & control
Randomized Controlled Trials as Topic
Risk Adjustment* / methods
Risk Assessment / methods
Risk Factors
Time-to-Treatment* / standards

Associated data

ClinicalTrials.gov/NCT02027896

Grants and funding

CIHR/Canada