title: Effect of in-hospital comprehensive geriatric assessment (CGA) in older people with hip fracture. The protocol of the Trondheim Hip Fracture trial.
abstract: BACKGROUND
  Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT) aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit.
  
  
  METHODS
  The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB) at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival.
  
  
  CONCLUSIONS
  We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT00667914.
authors.affiliation: Department of Geriatrics, St. Olav Hospital, University Hospital of Trondheim, Norway. olav.sletvold@ntnu.no
authors.forename: Olav
authors.initials: O
authors.lastname: Sletvold
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
authors.forename: Pernille
authors.initials: P
authors.lastname: Thingstad
authors.forename: Kristin
authors.initials: K
authors.lastname: Taraldsen
authors.forename: Anders
authors.initials: A
authors.lastname: Prestmo
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Lamb
authors.forename: Arild
authors.initials: A
authors.lastname: Aamodt
authors.forename: Roar
authors.initials: R
authors.lastname: Johnsen
authors.forename: Jon
authors.initials: J
authors.lastname: Magnussen
authors.forename: Ingvild
authors.initials: I
authors.lastname: Saltvedt
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006620:Hip Fractures / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D009664:Norway / Q000453:epidemiology; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome