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Blankstein, M.; Schemitsch, E.H.; Bzovsky, S.; Axelrod, D.; Poolman, R.W.; Frihagen, F.; ... ; FAITH & HEALTH Investigators (2020)

The FAITH and HEALTH trials: are we studying different hip fracture patient populations?

Article / Letter to editor
Background: Over the past decade, 2 randomized controlled trials were performed to evaluate 2 surgical strategies (internal fixation and arthroplasty) for the treatment of low-energy femoral neck fractures in patients aged >= 50 years. We evaluated whether patient populations in both the FAITH and HEALTH trials had different baseline characteristics and compared the displaced femoral neck fracture cohort from the FAITH trial to HEALTH trial patients. Methods: Patient demographics, medical comorbidities, and fracture characteristics from both trials were compared. FAITH trial patients with displaced fractures were then compared with HEALTH patients. T-tests and chi(2) tests were performed to compare differences for sex, age, osteoporosis status, and ASA class. Results: The mean age of the 1079 FAITH trial patients was 72 versus 79 years for the 1441 HEALTH trial patients. HEALTH patients were older, mostly White, used more medication, and had more comorbidities than FAITH patients....Show moreBackground: Over the past decade, 2 randomized controlled trials were performed to evaluate 2 surgical strategies (internal fixation and arthroplasty) for the treatment of low-energy femoral neck fractures in patients aged >= 50 years. We evaluated whether patient populations in both the FAITH and HEALTH trials had different baseline characteristics and compared the displaced femoral neck fracture cohort from the FAITH trial to HEALTH trial patients. Methods: Patient demographics, medical comorbidities, and fracture characteristics from both trials were compared. FAITH trial patients with displaced fractures were then compared with HEALTH patients. T-tests and chi(2) tests were performed to compare differences for sex, age, osteoporosis status, and ASA class. Results: The mean age of the 1079 FAITH trial patients was 72 versus 79 years for the 1441 HEALTH trial patients. HEALTH patients were older, mostly White, used more medication, and had more comorbidities than FAITH patients. Of the 1079 FAITH trial patients, 32% (346/1079) had displaced fractures. Their mean age was significantly lower than that of HEALTH patients (66 vs. 79 years; P < 0.001). HEALTH trial patients were significantly more likely to be female, have ASA classification Class III/IV/V, and carry a diagnosis of osteoporosis, as compared with the subgroup of FAITH patients with displaced femoral neck fractures (P < 0.001). Conclusion: This study demonstrates significant differences between patients enrolled in the 2 trials. Although both studies focused on femoral neck fractures with similar enrollment criteria, patient populations differed. This sheds light on a noteworthy limitation of discordant patient enrollment into randomized trials, despite similar eligibility criteria.Show less
baseline characteristics
femoral neck fracture
All authors
Blankstein, M.; Schemitsch, E.H.; Bzovsky, S.; Axelrod, D.; Poolman, R.W.; Frihagen, F.; Bhandari, M.; Swiontkowski, M.; Sprague, S.; Schottel, P.C.; FAITH & HEALTH Investigators
Date
2020-11-01
Journal
Journal of Orthopaedic Trauma
Volume
34
Pages
S1 - S8
DOI
doi:10.1097/BOT.0000000000001930
Link
https://journals.lww.com/jorthotrauma/Fulltext/2020/11003/The_FAITH_and_...