Clinical Research Directory

Nerve Block and Perioperative Myocardial Injury in Elderly Hip Fracture

This single-center, retrospective cohort study evaluates whether a single preoperative peripheral nerve block can reduce the risk of perioperative myocardial injury in elderly patients undergoing delayed hip fracture surgery, defined as surgery performed more than 48 hours after injury. Hip fracture is a serious and common injury in older adults worldwide. When surgery cannot be performed within the recommended 48-hour window, patients face a much higher risk of heart muscle damage (myocardial injury), which is strongly linked to increased complications and death. Peripheral nerve blocks are a standard, safe method for pain control in hip fracture care, but their potential protective effect on the heart has not been specifically studied in patients with delayed surgery. This study will review medical records of patients aged 65 years and older who received hip fracture surgery at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, between January 1, 2019 and December 31, 2025, with time from injury to surgery longer than 48 hours. Patients who received a single peripheral nerve block before surgery will be compared with patients who did not receive any peripheral nerve block. The main measure of the study is the rate of myocardial injury during hospital stay, detected by elevated troponin levels in routine blood tests. The study will also examine new-onset myocardial injury within 72 hours after surgery, major heart-related adverse events and all-cause death within 30 days after surgery, length of hospital stay, and other common postoperative complications. Researchers will also explore whether the timing of nerve block placement and different block techniques have different heart-protective effects. The findings may provide evidence for a simple, safe and practical strategy to reduce heart complications in older hip fracture patients who cannot receive timely surgery, and help clinicians improve perioperative care for this high-risk population.

Post-Operative Biomarker-Guided Precision Medicine For Cardiovascular Risk Reduction

The goal of this pilot study is to assess enrollment feasibility of a randomized trial of direct oral anticoagulant and high-intensity statin therapy versus usual care in patients with Myocardial Injury after Noncardiac Surgery (MINS). The primary aims of this study are to assess feasibility, study drug adherence, and optimize study design (entry criteria, study endpoints, sample size calculation, site selection) and recruitment strategies for the future multicenter randomized clinical trial studying biomarker-based care in post-operative patients at elevated cardiovascular (CV) risk.

Comparison of Myocardial Injury After Noncardiac Surgery (MINS) Incidence in Supine vs. Prone Positioning During Percutaneous Nephrolithotomy (PNL)

This prospective cohort study aims to compare the incidence of Myocardial Injury after Noncardiac Surgery (MINS) in patients undergoing percutaneous nephrolithotomy (PNL) for kidney stones in supine versus prone positioning. MINS is defined as an elevated postoperative troponin level (≥0.03 ng/mL) within 48 hours after surgery. Approximately 400 patients will be enrolled, with 200 patients in each positioning group (supine and prone). The primary outcome is the incidence of MINS, assessed through troponin measurements and electrocardiogram (ECG) findings. Secondary outcomes include intraoperative complications, duration of surgery, and postoperative recovery metrics. The study seeks to determine whether surgical positioning impacts MINS risk, potentially guiding safer surgical practices.