Effect of in-hospital comprehensive geriatric assessment (CGA) in older people with hip fracture. The protocol of the Trondheim Hip Fracture trial

Olav Sletvold, Jorunn L Helbostad, Pernille Thingstad, Kristin Taraldsen, Anders Prestmo, Sarah E Lamb, Arild Aamodt, Roar Johnsen, Jon Magnussen, Ingvild Saltvedt, Olav Sletvold, Jorunn L Helbostad, Pernille Thingstad, Kristin Taraldsen, Anders Prestmo, Sarah E Lamb, Arild Aamodt, Roar Johnsen, Jon Magnussen, Ingvild Saltvedt

Abstract

Background: Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT) aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit.

Methods/design: The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB) at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival.

Discussion: We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients.

Trials registration: ClinicalTrials.gov, NCT00667914.

© 2011 Sletvold et al; licensee BioMed Central Ltd.

Figures

Figure 1
Figure 1
Flowchart. Overview of patients and attrition rates at enrollment, index stay and follow-up 1, 4 and 12 months after the hip fracture. Attrition rates at all assessment time points are presented as estimated percentages of participants allocated into the study (%). The estimates are based on preliminary data from an observational study in our department.

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