Myocardial Injury in Patients with Hip Fracture

作者：Flávia K. Borges, Ernesto Guerra-Farfán, Mohit Bhandari, Ameen Patel, Gerard P. Slobogean, Robert J. Feibel, Parag Sancheti, Maria E. Tiboni, Mariano Balaguer‐Castro, Vikas Tandon, Jordi Tomàs-Hernández, Alben Sigamani, Alen Sigamani, Wojciech Szczeklik, Stephen J. McMahon, Paweł Ślęczka, Mmampapatla Thomas Ramokgopa, S. Adinaryanan, Masood Umer, Richard Jenkinson, Abdel‐Rahman Lawendy, Ekaterine Popova, Aamer Nabi Nur, Chew Yin Wang, Marcela P. Vizcaychipi, Bruce Biccard, Sandra Ofori, Jessica Spence, Emmanuelle Duceppe, Maura Marcucci, Valerie Harvey, Kumar Balasubramanian, Jessica Vincent, Ana Claudia Tonelli, P.J. Devereaux, the HIP ATTACK Investigators · 发表于：Journal of Bone and Joint Surgery · 年份：2024 · DOI：10.2106/jbjs.23.01459 · 被引用次数：12 · 研究领域：Hip and Femur Fractures、Cardiac, Anesthesia and Surgical Outcomes、Bone fractures and treatments

BACKGROUND: Myocardial injury after a hip fracture is common and has a poor prognosis. Patients with a hip fracture and myocardial injury may benefit from accelerated surgery to remove the physiological stress associated with the hip fracture. This study aimed to determine if accelerated surgery is superior to standard care in terms of the 90-day risk of death in patients with a hip fracture who presented with an elevated cardiac biomarker/enzyme measurement at hospital arrival. METHODS: The HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) trial was a randomized controlled trial designed to determine whether accelerated surgery for hip fracture was superior to standard care in reducing death or major complications. This substudy is a post-hoc analysis of 1392 patients (from the original study of 2970 patients) who had a cardiac biomarker/enzyme measurement (>99.9% had a troponin measurement and thus "troponin" is the term used throughout the paper) at hospital arrival. The primary outcome was all-cause mortality. The secondary composite outcome included all-cause mortality and non-fatal myocardial infarction, stroke, and congestive heart failure 90 days after randomization. RESULTS: Three hundred and twenty-two (23%) of the 1392 patients had troponin elevation at hospital arrival. Among the patients with troponin elevation, the median time from hip fracture diagnosis to surgery was 6 hours (interquartile range [IQR] = 5 to 13) in the accelerated surgery...