CompletedNCT02027896HIP ATTACKUpdated Jan 22, 2024

HIP Fracture Accelerated Surgical TreaTment And Care tracK (HIP ATTACK) Trial

An interventional study of Accelerated medical clearance and surgery in Hip Fractures, sponsored by McMaster University. Completed at 69 sites in 17 countries. Open to participants aged 45 Years and older. Per ClinicalTrials.gov, last updated 2024-01-22.

Sponsored by McMaster University · Not applicable, Interventional, and Treatment

Phase: Not applicable
Study type: Interventional
Enrollment: 3,001
Allocation: Randomized
Ages: 45 Years and older
Sex: All

Study summary

HIP ATTACK is an international randomized controlled trial of 3000 patients with a hip fracture that requires a surgical intervention. This trial will determine the effect of accelerated medical clearance and accelerated surgery compared to standard care on the 90-day risk of mortality and major perioperative complication (i.e., a composite of mortality, nonfatal myocardial infarction, nonfatal pulmonary embolism, nonfatal pneumonia, nonfatal sepsis, nonfatal stroke, and nonfatal life-threatening and major bleeding).

Conditions studied

Hip Fractures

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Keywords

Perioperative outcomes

In context

Fractures, Bone

2,261 studies on the registry are indexed under Fractures, Bone; 325 are open to participants now.

This study's enrollment of 3,001 is above the median of 69 across 1,482 interventional studies indexed under Fractures, Bone.

Browse Fractures, Bone studies →

Lead sponsor

McMaster University is the lead sponsor of 720 studies on the registry; 124 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 2 (33%) have results posted.

Counted across the registry records on this site, refreshed daily.

Who can participate

Ages eligible: 45 Years and older
Sexes eligible: All
Accepts healthy volunteers: No

Inclusion criteria

age ≥45 years; and
diagnosis of hip fracture during working hours with a low-energy mechanism (i.e., falling from standing height) requiring surgery.

Exclusion criteria

Exclusion Criteria:

patients requiring emergent surgery or emergent interventions for another reason (e.g., subdural hematoma, abdominal pathology requiring urgent laparotomy, acute limb ischemia, other fractures or trauma requiring emergent surgery, necrotising fasciitis, coronary revascularization, pacemaker-implantation);
open hip fracture;
bilateral hip fractures;
peri-prosthetic fracture;
therapeutic anticoagulation not induced by a Vitamin K Antagonist, unfractionated heparin, (e.g., administration of therapeutic Low Molecular Weight Heparin (LMWH) (>6,000 u/24h) in the 24 hours prior to enrolment, or intake of any other non-reversible oral anticoagulant(s) for which there is no reversing agent available
patients on a therapeutic vitamin K antagonist with a history of heparin induced thrombocytopenia (HIT);
patients refusing participation; or
patients previously enrolled in the study.

Study design

Phase: Not applicable
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel assignment
Masking: Single (Outcomes assessor)
Enrollment: 3,001 participants (actual)

Study arms

Experimental
Accelerated medical clearance and surgery
Rapid medical clearance with targeted arrival to the operating room within 6 hours of diagnosis of a hip fracture requiring surgical repair.
Other: Accelerated medical clearance and surgery
No intervention
Standard surgical care
Surgical hip fracture repair according to the standard timing.

Interventions

OtherAccelerated medical clearance and surgery
Rapid medical clearance with targeted arrival to the operating room within 6 hours of diagnosis of a hip fracture requiring surgical repair.

What researchers measure

Primary outcomes

Composite - major perioperative complication
Composite of mortality, nonfatal myocardial infarction, nonfatal pulmonary embolism, nonfatal pneumonia, nonfatal sepsis, nonfatal stroke, and nonfatal life-threatening and major bleeding
Time frame: 90 days
Mortality
All-cause mortality
Time frame: 90 days

Secondary outcomes

All-cause mortality
Death due to all causes
Time frame: 90 days and 1 year
Vascular mortality
Death due to vascular cause
Time frame: 90 days and 1 year
Non-vascular mortality
Death due to non-vascular cause
Time frame: 90 days and 1 year
Myocardial infarction
Myocardial infarction
Time frame: 90 days and 1 year
Cardiac revascularization procedure
i.e., percutaneous coronary intervention \[PCI\] or coronary artery bypass grafting \[CABG\] surgery
Time frame: 90 days and 1 year
New congestive heart failure
New congestive heart failure
Time frame: 90 days and 1 year
New clinically important atrial fibrillation
New clinically important atrial fibrillation
Time frame: 90 days
Nonfatal cardiac arrest
Nonfatal cardiac arrest
Time frame: 30 days and 1 year
Stroke
Stroke
Time frame: 90 days and 1 year
Peripheral arterial thrombosis
Peripheral arterial thrombosis
Time frame: 90 days and 1 year
Pulmonary embolism
Pulmonary embolism
Time frame: 90 days and 1 year
Deep venous thrombosis
Deep venous thrombosis
Time frame: 90 days and 1 year
Pneumonia
Pneumonia
Time frame: 90 days and 1 year
Sepsis
Sepsis
Time frame: 90 days and 1 year
Infection
Infection
Time frame: 90 days
Life-threatening bleeding
Life-threatening bleeding
Time frame: 90 days
Major bleeding
Major bleeding
Time frame: 90 days
New acute renal failure requiring dialysis
New acute renal failure requiring dialysis
Time frame: 90 days and 1 year
Peri-prosthetic fracture
Peri-prosthetic fracture
Time frame: 90 days and 1 year
Prosthetic hip dislocation
Prosthetic hip dislocation
Time frame: 90 days and 1 year
Implant failure
Implant failure
Time frame: 90 days and 1 year
Hip re-operation
Hip re-operation
Time frame: 30 days and 1 year
Time to first mobilization
Time to first mobilization
Time frame: 90 days
Length of hospital stay
Length of hospital stay
Time frame: 90 days
Length of critical care stay
Length of critical care stay
Time frame: 90 days
Length of rehabilitation stay
Length of rehabilitation stay
Time frame: 90 days
New residence in a nursing home
New residence in a nursing home
Time frame: 90 days and 1 year
Functional Independence Measure (FIM™)
Functional Independence Measure (FIM™)
Time frame: 30 days and 1 year
SF-36 score
SF-36 score
Time frame: 30 days and 1 year
Delirium within 7 days of randomization
Delirium within 7 days of randomization
Time frame: 7 days
Hospital readmission
Hospital readmission
Time frame: 90 days and 1 year
New pressure ulcers
New pressure ulcers
Time frame: 90 days
Incisional pain
Incisional pain
Time frame: 30 days
Chronic incisional pain
Chronic incisional pain
Time frame: 1 year
Acute Kidney Injury
Acute Kidney Injury
Time frame: 90 Day
Acute Kidney Injury
Acute Kidney Injury
Time frame: 1 Year
Mortality and Institutionalization status of dependents
Mortality and Institutionalization status of dependents
Time frame: 30 Days
Mortality and Institutionalization status of dependents
Mortality and Institutionalization status of dependents
Time frame: 1 Year
Economic Analysis
Economic Analysis
Time frame: 90 Days and 1 Year
Health System Utilization, Long Term Follow up
Health System Utilization, Long Term Follow up
Time frame: 2, 5, 10 Years

Study locations

69 sites

Regional Medical Center of San Jose
San Jose, California, United States
University of Maryland
Baltimore, Maryland 20742, United States
Lahey Hospital and Medical Centre
Burlington, Massachusetts 01805, United States
Tufts Medical Centre
Washington, Massachusetts 02111, United States
Ohio State University Medical Centre
Columbus, Ohio 43210, United States
Cliniques Universitaires Saint-Luc
Brussels, Belgium
Cliniques Universitaires Saint-Luc
Woluwe-Saint-Lambert, Belgium
South Health Campus
Calgary, Alberta, Canada
University of Alberta Hospital
Edmonton, Alberta, Canada
Vancouver General Hospital
Vancouver, British Columbia, Canada
Concordia Hip and Knee Institute
Winnipeg,, Manitoba MB R2K 2M9, Canada
QEII Health Sciences
Halifax,, Nova Scotia B3H 3A7, Canada
Royal Victoria Hospital
Barrie, Ontario, Canada
Etobicoke General Hospital
Etobicoke, Ontario, Canada
St. Joseph's Hospital Hamilton
Hamilton, Ontario L8N 4A6, Canada
Hamilton Health Sciences - Juravinski Hospital
Hamilton, Ontario L8V 5C2, Canada
Kingston General Hospital
Kingston, Ontario K7L 2V7, Canada
Grand River Hospital
Kitchener, Ontario, Canada
Victoria Hospital, London Health Sciences
London, Ontario, Canada
Markham Stouffville Hospital
Markham, Ontario, Canada
Ottawa General Hospital
Ottawa, Ontario K1H 8L6, Canada
Thunder Bay Regional Health Sciences Centre
Thunder Bay, Ontario P7B 6V4, Canada
Humber River Hospital
Toronto, Ontario M3M 0B2, Canada
St. Michael's Hospital
Toronto, Ontario, Canada
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada
Beijing Chaoyang Hospital
Beijing, China
Fundacion Cardioinfantil
Bogotá, 13B-60, Colombia
Centre Hospitalier Lyon Sud
Lyon, France
Nimes University Hospital
Nîmes Cedex 09, 30029, France
Queen Mary Hospital
High West, Hong Kong
Government TD Medical College
Alappuzha, 688005, India
Sparsh Hospital
Bangalore, 560099, India
PGIMER
Chandigarh, India
Bangalore Baptist Hospital
Hebbal, 560024, India
NH Kolkata
Kolkata, 700099, India
CMC Ludhiana
Ludhiana, 141008, India
Seven Star Hospital
Nagpur, India
AIIMS Hospital
New Delhi, India
JIPMER
Puducherry, India
Sancheti Institute for Orthopaedics and Rehabilitation
Shivajinagar, 411005, India
Government Medical Hospital
Trivandrum, India
Ospedale San Raffaele
Milan, 20132, Italy
Humanitas Research Hospital
Milan, Italy
IRCCS Galeazzi Orthopedic Institute
Milan, Italy
ASST Sette Laghi - Ospedale Di
Varese, Italy
Hospital Pulau Pinang
George Town, Malaysia
University Malaya Medical Centre (UMMC)
Kuala Lumpur, 59100, Malaysia
Deventer Ziekenhuis
Deventer, Netherlands
Shifa International Hospitals
Islāmābād, 44000, Pakistan
The Aga Khan University
Karachi, 74800, Pakistan
SPZOZ Szpital Powiatowy w Bochni im M. Wieckiej
Bochnia, Poland
Samodzielny Publiczny Zakład Opieki Zdrowotnej W Myślenicach
Myślenice, 32-400, Poland
University Hospital & Educational Center of Medical University in Lodz
Łódź, Poland
Groote Schuur Hospital
Cape Town, 7925, South Africa
Stellenbosch University
Cape Town, South Africa
Chris Hani Baragwanath Hospital
Johannesburg, 2193, South Africa
Hospital San Pau
Barcelona, 08025, Spain
Hospital Universitaire Vall d'Hebron
Barcelona, 08035, Spain
Corporació Sanitària Parc Taulí
Barcelona, 08208, Spain
Mutua de Terrassa Hospital
Barcelona, 08221, Spain
Hospital Sant Camil (Consorci Sanitari Garraf)
Barcelona, Spain
Costa del Sol
Marbella, 29603, Spain
Hospital Clinico Universitario de Vallad
Valladolid, Spain
Ramathibodi Hospital
Bangkok,, 10400, Thailand
Calderdale & Huddersfield NHS
Huddersfield, United Kingdom
Chelsea and Westminster Hospital
London, SW10 9NH, United Kingdom
West Middlesex Hospital
London, United Kingdom
Peterborough City Hospital
Peterborough, United Kingdom
King's Mill Hospital
Sutton in Ashfield, NG17 4JL, United Kingdom

References and documents

Publications

HIP ATTACK Investigators. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial. Lancet. 2020 Feb 29;395(10225):698-708. doi: 10.1016/S0140-6736(20)30058-1. Epub 2020 Feb 9. Erratum In: Lancet. 2021 Nov 27;398(10315):1964. doi: 10.1016/S0140-6736(21)02430-2. Lancet. 2023 Apr 1;401(10382):1078. doi: 10.1016/S0140-6736(23)00629-3. PubMed 32050090 ↗
Borges FK, Devereaux PJ, Cuerden M, Bhandari M, Guerra-Farfan E, Patel A, Sigamani A, Umer M, Neary J, Tiboni M, Tandon V, Ramokgopa MT, Sancheti P, John B, Lawendy A, Balaguer-Castro M, Jenkinson R, Sleczka P, Nabi Nur A, Wood GCA, Feibel R, McMahon JS, Sigamani A, Biccard BM, Landoni G, Szczeklik W, Wang CY, Tomas-Hernandez J, Abraham V, Vincent J, Harvey V, Pettit S, Sontrop J, Garg AX; HIP ATTACK investigators. 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. PubMed 31551393 ↗
Borges FK, Bhandari M, Patel A, Avram V, Guerra-Farfan E, Sigamani A, Umer M, Tiboni M, Adili A, Neary J, Tandon V, Sancheti PK, Lawendy A, Jenkinson R, Ramokgopa M, Biccard BM, Szczeklik W, Wang CY, Landoni G, Forget P, Popova E, Wood G, Nabi Nur A, John B, Sleczka P, Feibel RJ, Balaguer-Castro M, Deheshi B, Winemaker M, de Beer J, Kolesar R, Teixidor-Serra J, Tomas-Hernandez J, McGillion M, Shanthanna H, Moppett I, Vincent J, Pettit S, Harvey V, Gauthier L, Alvarado K, Devereaux PJ. Rationale and design of the HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) Trial: a protocol for an international randomised controlled trial evaluating early surgery for hip fracture patients. BMJ Open. 2019 May 1;9(4):e028537. doi: 10.1136/bmjopen-2018-028537. PubMed 31048449 ↗

Updates

Tracking since Sep 25, 2026

No changes since tracking began. The registry record was last updated on Jan 22, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗

Registry details

Key details

Study ID: NCT02027896
Lead sponsor: McMaster University
Collaborators: Population Health Research Institute, Hamilton Health Sciences Corporation
Responsible party: Sponsor
First posted: Jan 6, 2014
Start date: Mar 14, 2014
Primary completion: Aug 24, 2019
Completion: Sep 30, 2022
Last update: Jan 22, 2024

Study contacts

Philip J Devereaux, MD, PhD

principal investigator · McMaster University

Mohit Bhandari, MD, PhD

principal investigator · McMaster University

Oversight

Data monitoring committee: Yes

View the source record on ClinicalTrials.gov ↗

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