Effects of Fast-tracking Geriatric Hip Fracture Patients

February 12, 2021 updated by: Mattias Lorentzon, Sahlgrenska University Hospital, Sweden

Effects of Fast-tracking Hip Fracture Patients in Geriatric Medicine Wards on Complication Incidence and Time of Hospitalization

The purpose of this study is to determine whether fast-tracking hip fracture patients to geriatric medicine wards, as opposed to standard care at the emergency room, results in less complications and shorter hospitalization for the patients.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Detailed Description

Each year about 18000 persons in Sweden suffer from a hip fracture. These people are often among the oldest and have many complicating diseases. The one-year mortality after hip fracture is 20%. Due to the complexity including many comorbidities in these patients, it is of great value that the care of these patients is optimal.

Today, most of the patients with suspected hip fracture in the catchment area of Sahlgrenska University hospital, Gothenburg, are transported directly to the radiology unit. Thereafter, the patient waits in the emergency room (ER) for an othopedic examination before being admitted to primarily a geriatric medicine ward where they wait for the operation. The average waiting time in the ER is today around four hours. The current scientific evidence for fast-tracking hipfracture patients is limited. The aim of our randomized controlled trial is to determine the effect of fast-tracking hip fracture patients at geraitric medicine wards compared to standard care regarding complication rate (primary endpoint), lenght of hospital stay and time to operation (secondary outcomes).

Study Type

Interventional

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Sweden
      • Gothenburg, Sweden
        • Sahlgrenska University hospital, Mölndal

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

65 years and older (OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • patients with low energy trauma with pain at the hip and/or groin AND
  • respiratory frequency: 8-25/minute AND
  • saturation: 90% or higher on air AND
  • pulse: 50-119 beats per minute AND
  • systolic blood pressure: >90 mmHg AND
  • level of consciousness: Reaction level scale (RLS) 1 or Glasgow Coma Scale (GCS) 14-15 AND
  • plasma-glucose: 3,0-25 mmol/l

Exclusion Criteria:

We will exclude patients based on the following criteria:

  • distal status affected
  • suspicion of other simultaneous fracture
  • suspicion of head trauma or affected consciousness
  • suspicion of acute cardiac disease
  • signs of acute cardiac ischemia in electrocardiogram
  • generalized symtoms, except for pain in the hip

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: SUPPORTIVE_CARE
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Fast-tracking at geriatric medicine ward
Fast-tracking hip fracture patients at geriatric medicine ward. The goal is to optimize the medical care of older hip fracture patients at a geriatric ward and to shorten the time to operation.
Procedure: Fast-tracking
NO_INTERVENTION: Regular admission
Regular admission and care of hip fracture patients at the emergency room prior to surgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Incidence of complications (composit endpoint of non-fatal major bleeding, pressure ulcer, non-fatal infections, confusion, non-fatal tromboembolic events, all-cause mortality)
Time Frame: at time of discharge from geriatric medicine ward, after four months and after one year
at time of discharge from geriatric medicine ward, after four months and after one year

Secondary Outcome Measures

Outcome Measure
Time Frame
Length of hospital stay, time to operation, all-cause mortality, functional ability after discharge, proportion of patients returning to former living, self assessed health status
Time Frame: At time of discharge from geriatric medicine ward, after four months and after one year
At time of discharge from geriatric medicine ward, after four months and after one year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sahlgrenska University Hospital, Sweden

Investigators

  • Principal Investigator: Mattias Lorentzon, MD, PhD, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2013

Primary Completion (ANTICIPATED)

June 1, 2016

Study Completion (ANTICIPATED)

June 1, 2017

Study Registration Dates

First Submitted

June 10, 2013

First Submitted That Met QC Criteria

February 12, 2021

First Posted (ACTUAL)

February 16, 2021

Study Record Updates

Last Update Posted (ACTUAL)

February 16, 2021

Last Update Submitted That Met QC Criteria

February 12, 2021

Last Verified

February 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • dnr 154-13

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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