Hip Fractures (ICD-10 72.01-72.2)
Conditions
Keywords
hip fracture, pneumonia, PEP therapy, positive expiratory pressure, RCT, hospital-acquired pneumonia, systematic treatment with PEP, osteoporosis, frailty, multimorbidity
Brief summary
The goal of this clinical trial is to investigate whether pre- and postoperative treatment with systematic PEP therapy can prevent hospital-acquired pneumonia in patients with hip frac-ture. It will also learn about the barriers regarding PEP therapy in this group of patients. * Does pre- and postoperative treatment with systematic PEP therapy prevent hospital-acquired pneumonia in patients with hip fracture? * Which barriers do participants have regarding PEP therapy in this group of patients? Researchers will compare systematic PEP therapy to no intervention besides standard treat-ment to see if systematic therapy with PEP can prevent hospital-acquired pneumonia. Participants will: * Receive systematic PEP therapy during hospitalization or no intervention besides standard treatment * Register the PEP therapy four times daily on a paper checklist. Failure to perform the treatment and the reason must also be documented on the checklist.
Interventions
PEP therapy
Sponsors
University Hospital Bispebjerg and Frederiksberg
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Hip fracture regardless of age * Cognitively well-functioning * Able to understand the study and give informed consent * Able to speak and understand Danish * Resident of Region Hovedstaden or Region Sjælland
Exclusion criteria
* Cognitively impaired * Unable to understand the study and give informed consent * Pneumonia upon admission * Delirium upon admission * Pneumothorax For patients with e.g. dementia or brain injury, the ability to give informed consent will be assessed individually.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of hospital-acquired pneumonia | During hospitalization, from intervention start to discharge, which is on average one week | Primary Outcome is the incidence of hospital-acquired pneumonia in the control and intervention group. Documented in the Sundhedsplatformen and diagnosed with one ore more of the following: * Thoracic x-ray * Sputum culture * Auscultation * Infection markers |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants dead within 30-days after discharge | 30-day mortality, assessed 30 days after discharge from the orthopedic ward | Number of participants dead within 30 days after discharge |
| Number of participants readmitted within 30-days after discharge | 30-day readmission post-discharge, assessed 30 days after discharge from the orthopedic ward | Number of participants readmitted within 30 days after discharge |
| Incidence of delirium during hospitalization (journal entry, CAM-screening, diagnosis), up to 4 weeks. | During hospitalization, from intervention start to discharge, which is on average one week | Incidence of delirium during hospitalization (journal entry, CAM-screening, diagnosis), up to 4 weeks. |
| Degree of regained basic mobility (Cumulated Ambulation Score - CAS) on the the day of discharge compared to the assement made at admission. | CAS the weeks up to hip fracture and CAS at discharge, which is on average one week after admission | Degree of regained basic mobility (Cumulated Ambulation Score - CAS) on the the day of discharge compared to the assement made at admission. CAS values ranges from 0 to 6. A score of 6 represents an independant patient in regards to getting in and out of bed, sit-to-stand from a chair, and walking. A score of 0 represents a patient completely dependant on help getting in and out of bed, sit-to-stand from a chair, and walking. |
| Discharge destination (home, nursing home, care facility, rehab, another ward/hospital, etc.). Number of participants discharged to home, care facility, rehab, another hospital/ward or ot he discharge destination. | Assessed at discharge from the orthopedic department, which is on average one week efter admission | Discharge destination (home, nursing home, care facility, rehab, another ward/hospital, etc.). Number of participants discharged to home, care facility, rehab, another hospital/ward or o the discharge destination. |
Countries
Denmark
Outcome results
None listed