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National study aims to improve recovery outcomes for hip fracture patients: Research

Dr Andrew Kane at James Cook

Consultant anaesthetists, Dr Andrew Kane and Professor Gerard Danjoux from University Hospitals Tees are recruiting 100 patients with a broken hip to take part in a randomised clinical trial.  

Many patients experience low blood pressure during surgery, which can be harmful to their heart, kidneys or brain, particularly in elderly patients who are living with frailty.  

The CAREFUL study

The continuous arterial monitoring in elderly and frail patients for hip fracture surgery to prevent low blood pressure (CAREFUL) study aims to investigate whether continuous monitoring of blood pressure for every heartbeat could improve care for older patients living with frailty who have broken their hip.  

100 patients will take part in the trial funded by the National Institute for Health and Care Research (NIHR).  

Half of the patients will receive blood pressure readings taken every five minutes during surgery, which is the current practice.  

The other half will receive continuous beat-to-beat monitoring which means every beat will be measured continuously without any interruptions. This will require an ‘arterial line’ where an extra drip will be inserted into an artery at the wrist with local anaesthetic.  

Whilst this is done for other operations, it is relatively rare for hip fracture surgery.  

Improving outcomes

Consultant anaesthetist Dr Andrew Kane

Lead investigator, Dr Andrew Kane who works as a consultant at The James Cook University Hospital said: “We know low blood pressure during surgery can be harmful for patients.  

“If we monitor blood pressure during every heartbeat, we may pick up on low blood pressure sooner, treat it, prevent harm and in turn improve recovery outcomes.” 

Alongside his role as a consultant anaesthetist, Professor Danjoux is also the academic lead for perioperative medicine at James Cook.  

He said: “Every year 70 000 people break their hip in England- if this treatment is effective, that’s a lot of patients whose health and wellbeing could benefit from this simple procedure.” 

Get involved

Patients will be recruited from Autumn 2025. The study will be led by the North Yorkshire Academic Alliance of Perioperative Medicine and the Academic Centre for Surgery at South Tees Hospitals NHS Foundation Trust in partnership with the University of York and Hull York Medical School.   

If you would like to get involved in the study, please email: [email protected] 

Funding is supported via the NIHR Research for Patient Benefit (RfPB) Programme which aims to fund topics and research methodologies that increase the effectiveness of NHS services and benefit patient care.