Pain as a Driver of Myocardial Injury in Hip Fracture Patients: A Hip Fracture Accelerated Surgical Treatment and Care Track (HIP ATTACK) Trial Secondary Analysis
Authors' conclusion
Increased pain may be associated with myocardial ischemic events in the perioperative period in hip fracture patients.
Study context
- Population
- Patients undergoing hip fracture surgery in the HIP ATTACK trial with at least one troponin and one pain score measurement82% of HIP ATTACK cohort
- Participants
- 2,430 patients
- Comparison
- Moderate or severe vs mild perioperative pain
- Primary endpoint
- Troponin elevation from any cause
Methodological detailsmulticenter international, multivariable regression adjusted
- Multicenter international
- Multivariable regression adjusted
Primary result
As reported in the abstract
Each group vs mildOdds ratio (95% CI)
Moderate
3.90(3.02–5.05)
Severe
29.24(17.7–48.29)
- Troponin elevation from any cause, overall
- 1,098 (45%)
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| Myocardial injury (ischemic etiology)Moderate vs Mild | 2.09 (1.71–2.57) | |
| Myocardial injury (ischemic etiology)Severe vs Mild | 6.04 (4.49–8.12) | |
| MISevere vs Mild | 2.33 (1.35–3.99) | |
| 0.10.31310Odds ratio (log scale) |
MI
- Only severe pain associated with MI
Composite of myocardial injury and MI
- Both moderate and severe pain associated with the composite outcome
Original publication
Pain as a Driver of Myocardial Injury in Hip Fracture Patients: A Hip Fracture Accelerated Surgical Treatment and Care Track (HIP ATTACK) Trial Secondary Analysis. Anesthesiology. Published 27 October 2025. doi:10.
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