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NCT07556263
Hip fractures in especially older adults cause severe clinical and functional impacts. Despite improved surgical care, one year mortality remains 14-30%, and fewer than half of the survivors regain their pre-fracture functional status. After a hip fracture, patients are primarily concerned with what they will be able to do in daily life. Wihout accurate predictions of mobility and Activities of Daily Life (ADL) independence, it is difficult to set realistic expectations and make appropriate decisions regarding treatment and rehabilitation. While there have been advancements in developing predictive models for mortality following hip fractures, there is a notable gap in models focused on predicting functional recovery. This study aims to develop and validate a machine learning-based model that can predict mobility and ADL independence three months after obtaining a hip fracture.
NCT07443566
This study is a 10-year follow-up of a previously enrolled cohort of patients who underwent surgery for acute hip fracture with spinal anesthesia and had pre-fracture cognitive status assessed (Clinical Dementia Rating, CDR) and cerebrospinal fluid (CSF) biomarkers related to Alzheimer's disease measured (e.g., Aβ42/Aβ40 ratio, total tau, phosphorylated tau). The primary aim is to determine long-term survival at 10 years after index hip fracture surgery and to evaluate whether baseline cognitive status and/or Alzheimer-type CSF biomarker profiles are associated with long-term mortality.
NCT07189260
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.
NCT06678529
To evaluate the efficacy of transcranial direct current stimulation (tDCS) in reducing the incidence of postoperative delirium (POD) in elderly patients undergoing hip fracture surgery. This single-center, double-blind, randomized controlled trial will enroll participants aged 65 years and older, scheduled for elective hip surgery under spinal anesthesia. Participants will be randomly assigned to either the active-tDCS group or the sham-tDCS group. The active-tDCS group will receive two sessions: one pre-surgery and one post-surgery, with electrodes positioned over the left dorsolateral prefrontal cortex and the right supraorbital area. Each session includes 15-second ramp-up phase at the start, 20 minutes simulation with 2 mA current and 15-second ramp-down phase at the end. The sham-tDCS group will receive two sham procedures with no actual current delivered. Functional brain activity will be monitored before and after each session or sham procedure to assess changes in cortical activation and connectivity using functional near-infrared spectroscopy (fNIRS). The primary outcome measure will be the incidence of POD, assessed using the 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM). Secondary outcomes include the severity of delirium, postoperative pain, anxiety, depression, cognitive function, and sleep quality.
NCT06700031
With simple technology investigators can map how long it takes for a patient with a hip fracture to be helped and encouraged to stand and walk in the days following the injury. A small sensor on the thigh can measure advanced data regarding movement patterns. The limited research results available show that patients spend too much time lying down or sitting, which can lead to poorer recovery, complications, and an increased risk of death. The project maps the current situation in orthopedic emergency care as well as in orthopedic geriatric care, which is provided in a modern building with single rooms and private bathrooms. In addition to better understanding the significance of different care models, the project aims to present baseline data that future intervention studies can use as control material. The project will also connect the activity level of the patients during the hospital stay with ongoing rehabilitation studies in community follow-up care.
NCT04026022
Aim of the study is an examination whether a modified perioperative pain management system, that integrates the 2017 European Society of Anaesthesiology (ESA) guidelines for treatment of postoperative Delirium, can improve patient's wellbeing in comparison to the current certified standard management.