RESULT-Hip. The impact of restrictive compared with liberal transfusion strategy on cardiac injury and death in patients undergoing surgery for hip fracture : protocol for a multicentre, randomized controlled trial of two blood transfusion strategies.
9 affiliations
- 1Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
- 2Edinburgh Clinical Trials Unit, The University of Edinburgh, Edinburgh, UK.
- 3Royal Infirmary of Edinburgh, Edinburgh, UK.
- 4The University of Edinburgh, Edinburgh, UK.
- 5ICU Steps, London, UK.
- 6Queen Mary University of London, London, UK.
- 7Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
- 8Anaesthesia, Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
- 9NHS Blood and Transplant and Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Abstract
Aims
Hip fracture is a global health issue. Complications are common, leading to reduced quality of life or death. These occur more frequently if anaemia is present. We hypothesize that correcting anaemia in the perioperative period may decrease major adverse cardiac events (MACE) and death after hip fracture.Methods
This multicentre prospective randomized trial compares transfusion strategies after hip fracture in patients aged ≥ 60 years. We initially planned to randomize 1,984 participants with anaemia, defined as haemoglobin ≤ 90 g l⁻¹, to one of two transfusion strategies: liberal transfusion (aim haemoglobin 90 g l⁻¹ to 110 g l⁻¹), or restrictive transfusion (aim 75 g l⁻¹ to 90 g l⁻¹). The intervention lasts from randomization to hospital discharge or 30 days post randomization, whichever is soonest. The primary outcome measure was a composite of death or MACE adjudicated by blinded clinical experts. Secondary outcomes included all-cause mortality and quality of life, evaluated at 120 days. Cost-effectiveness and health economic evaluation will also be reported.Results
This trial was funded by the National Institute for Health and Care Research, HTA award (National Institute for Health and Care Research (NIHR) 130875) and registered at ISRCTN 28818784. Ethical approval was obtained to recruit patients in the UK. As recruitment fell short of the initial target, and following consultation with the funder, we refined our primary outcome to include myocardial injury after non-cardiac surgery (MINS), and reduced the required sample size to 842.Conclusion
Recruitment commenced on 10 June 2022. The first participant was recruited on 16 June 2022. We will engage clinicians and healthcare planners to implement the findings. We plan to recruit until 31 October 2026. Results will be disseminated to clinicians, policymakers, patients, and the public.
Related
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- TRANSFUSION PROFILE AND RED BLOOD CELL CONCENTRATE UTILIZATION IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY AT A REFERRAL HOSPITAL IN THE BRAZILIAN AMAZON REGION
- PREOPERATIVE HEMOGLOBIN AS A PREDICTOR OF TRANSFUSION REQUIREMENT IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY
- Statistical analysis plan for transfusion of modified whole blood versus blood components therapy in patients with severe trauma: randomized controlled trial - WEBSTER trial.
BibTeX
@article{group2026resulthip,
title = {{RESULT-Hip. The impact of restrictive compared with liberal transfusion strategy on cardiac injury and death in patients undergoing surgery for hip fracture : protocol for a multicentre, randomized controlled trial of two blood transfusion strategies.}},
author = {RESULT Hip Study Group and Rhona C F Sinclair and Gayle Beveridge and Andrew D Duckworth and Annabel Giddings and Stephanie Cholbi and George V Guy and Sophie Birch and David A Hope and Joanne Singleton and Lucy Macdonald and Catriona Keerie and Julia Boyd and Alixe H M Kilgour and Alasdair MacLullich and Annemarie B Docherty and Carol Porteous and Matthew L Costa and Nicholas L Mills and Iain K Moppett and Rupert M Pearse and Simon J Stanworth and Andrew Stoddart and Steff Lewis and Timothy S Walsh and Michael A Gillies},
journal = {Bone \& joint open},
year = {2026},
month = oct,
doi = {10.1302/2633-1462.710.bjo-2026-0131.r1},
url = {https://europepmc.org/article/MED/42893795},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - RESULT-Hip. The impact of restrictive compared with liberal transfusion strategy on cardiac injury and death in patients undergoing surgery for hip fracture : protocol for a multicentre, randomized controlled trial of two blood transfusion strategies.
AU - RESULT Hip Study Group
AU - Rhona C F Sinclair
AU - Gayle Beveridge
AU - Andrew D Duckworth
AU - Annabel Giddings
AU - Stephanie Cholbi
AU - George V Guy
AU - Sophie Birch
AU - David A Hope
AU - Joanne Singleton
AU - Lucy Macdonald
AU - Catriona Keerie
AU - Julia Boyd
AU - Alixe H M Kilgour
AU - Alasdair MacLullich
AU - Annemarie B Docherty
AU - Carol Porteous
AU - Matthew L Costa
AU - Nicholas L Mills
AU - Iain K Moppett
AU - Rupert M Pearse
AU - Simon J Stanworth
AU - Andrew Stoddart
AU - Steff Lewis
AU - Timothy S Walsh
AU - Michael A Gillies
PY - 2026
DA - 2026/10/19
JO - Bone & joint open
DO - 10.1302/2633-1462.710.bjo-2026-0131.r1
UR - https://europepmc.org/article/MED/42893795
AB - Aims Hip fracture is a global health issue. Complications are common, leading to reduced quality of life or death. These occur more frequently if anaemia is present. We hypothesize that correcting anaemia in the perioperative period may decrease major adverse cardiac events (MACE) and death after hip fracture.Methods This multicentre prospective randomized trial compares transfusion strategies after hip fracture in patients aged ≥ 60 years. We initially planned to randomize 1,984 participants with anaemia, defined as haemoglobin ≤ 90 g l⁻¹, to one of two transfusion strategies: liberal transfusion (aim haemoglobin 90 g l⁻¹ to 110 g l⁻¹), or restrictive transfusion (aim 75 g l⁻¹ to 90 g l⁻¹). The intervention lasts from randomization to hospital discharge or 30 days post randomization, whichever is soonest. The primary outcome measure was a composite of death or MACE adjudicated by blinded clinical experts. Secondary outcomes included all-cause mortality and quality of life, evaluated at 120 days. Cost-effectiveness and health economic evaluation will also be reported.Results This trial was funded by the National Institute for Health and Care Research, HTA award (National Institute for Health and Care Research (NIHR) 130875) and registered at ISRCTN 28818784. Ethical approval was obtained to recruit patients in the UK. As recruitment fell short of the initial target, and following consultation with the funder, we refined our primary outcome to include myocardial injury after non-cardiac surgery (MINS), and reduced the required sample size to 842.Conclusion Recruitment commenced on 10 June 2022. The first participant was recruited on 16 June 2022. We will engage clinicians and healthcare planners to implement the findings. We plan to recruit until 31 October 2026. Results will be disseminated to clinicians, policymakers, patients, and the public.
SN - 2633-1462
ER -