Related Experiment Video

Updated: Jan 30, 2026

Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
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Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position

Published on: August 17, 2017

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A 1-year perspective on goal-directed therapy in elderly with hip fracture: Secondary outcomes

Erzsebet Bartha1,2, Thomas Davidson3, Hans E Berg2,4

  • 1Perioperative Medicine and Intensive Care, Karolinska University Hospital, Huddinge, Stockholm, Sweden.

Acta Anaesthesiologica Scandinavica
|January 19, 2019
PubMed

Insights

Goal-directed therapy (GDT) and routine fluid treatment (RFT) showed no significant differences in survival or complications for elderly hip fracture patients. Further large-scale research is needed to clarify effectiveness and cost-effectiveness.

Area of Science:

  • Geriatric Medicine
  • Anesthesiology
  • Health Economics

Background:

  • Previous randomized controlled trial (RCT) on elderly hip fracture patients comparing goal-directed therapy (GDT) with routine fluid treatment (RFT) yielded inconclusive results.
  • This study aimed to evaluate secondary outcomes and cost-effectiveness at 4 months and 1 year post-intervention.

Purpose of the Study:

  • To compare long-term survival, complication rates, hospital readmissions, and quality of life (EQ-5D) between GDT and RFT in elderly hip fracture patients.
  • To analyze the cost-effectiveness of GDT versus RFT using a combined approach of clinical effectiveness, quality of life, and costs.

Main Methods:

  • Elderly patients (age ≥70) with hip fracture were randomized to either GDT or RFT.
  • Secondary outcomes included survival, complications, readmissions, and EQ-5D changes at 4 months and 1 year.
  • Cost-effectiveness was assessed using a dedicated analytical tool.

Main Results:

  • No statistically significant differences were observed between GDT and RFT regarding survival (RR 0.76, 95%CI 0.45-1.28) or complications (RR 0.68, 95% CI 0.4-1.10) at 12 months.
  • Analysis of intention-to-treat data (GDT n=74; RFT n=75) revealed no significant differences in hospital readmissions or quality of life changes.

Conclusions:

  • The statistical uncertainty and data variability highlight the need for larger sample sizes in future research.
  • Incorporating patient-oriented outcomes in subsequent trials is recommended for robust health economic evaluations and decision support regarding GDT implementation.
Abstract

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