Abstract
Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p<0·0001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0·91 (95% CI 0·72 to 1·14) and absolute risk reduction (ARR) of 1% (−1 to 3; p=0·40). Major complications occurred in 321 (22%) patients assigned to accelerated surgery and 331 (22%) assigned to standard care, with an HR of 0·97 (0·83 to 1·13) and an ARR of 1% (−2 to 4; p=0·71). Interpretation: Among patients with a hip fracture, accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care. Funding: Canadian Institutes of Health Research.
| Original language | English |
|---|---|
| Pages (from-to) | 698-708 |
| Number of pages | 11 |
| Journal | The Lancet |
| Volume | 395 |
| Issue number | 10225 |
| DOIs | |
| Publication status | Published - 29 Feb 2020 |
Access to Document
Other files and links
Fingerprint
Dive into the research topics of 'Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial'. Together they form a unique fingerprint.Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
In: The Lancet, Vol. 395, No. 10225, 29.02.2020, p. 698-708.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Accelerated surgery versus standard care in hip fracture (HIP ATTACK)
T2 - an international, randomised, controlled trial
AU - Borges, Flavia K.
AU - Bhandari, Mohit
AU - Guerra-Farfan, Ernesto
AU - Patel, Ameen
AU - Sigamani, Alben
AU - Umer, Masood
AU - Tiboni, Maria E.
AU - Villar-Casares, Maria del Mar
AU - Tandon, Vikas
AU - Tomas-Hernandez, Jordi
AU - Teixidor-Serra, Jordi
AU - Avram, Victoria RA
AU - Winemaker, Mitchell
AU - Ramokgopa, Mmampapatla T.
AU - Szczeklik, Wojciech
AU - Landoni, Giovanni
AU - Wang, Chew Yin
AU - Begum, Dilshad
AU - Neary, John D.
AU - Adili, Anthony
AU - Sancheti, Parag K.
AU - Lawendy, Abdel Rahman
AU - Balaguer-Castro, Mariano
AU - Ślęczka, Paweł
AU - Jenkinson, Richard J.
AU - Nur, Aamer Nabi
AU - Wood, Gavin CA
AU - Feibel, Robert J.
AU - McMahon, Stephen J.
AU - Popova, Ekaterine
AU - Biccard, Bruce M.
AU - Moppett, Iain K.
AU - Forget, Patrice
AU - Landais, Paul
AU - McGillion, Michael H.
AU - Vincent, Jessica
AU - Balasubramanian, Kumar
AU - Harvey, Valerie
AU - Garcia-Sanchez, Yaiza
AU - Pettit, Shirley M.
AU - Gauthier, Leslie P.
AU - Guyatt, Gordon H.
AU - Conen, David
AU - Garg, Amit X.
AU - Bangdiwala, Shrikant I.
AU - Belley-Cote, Emilie P.
AU - Marcucci, Maura
AU - Lamy, Andre
AU - Whitlock, Richard
AU - Le Manach, Yannick
AU - Fergusson, Dean A.
AU - Yusuf, Salim
AU - Devereaux, P. J.
AU - Veevaete, Laurent
AU - le Polain de Waroux, Bernard
AU - Lavand'homme, Patricia
AU - Cornu, Olivier
AU - Tribak, Karim
AU - Yombi, Jean Cyr
AU - Touil, Nassim
AU - Reul, Maike
AU - Bhutia, Jigme Tshering
AU - Clinckaert, Carol
AU - De Clippeleir, Dirk
AU - de Beer, Justin
AU - Simpson, Diane L.
AU - Worster, Andrew
AU - Alvarado, Kim A.
AU - Gregus, Krysten K.
AU - Lawrence, Kelly H.
AU - Leong, Darryl P.
AU - Joseph, Philip G.
AU - Magloire, Patrick
AU - Deheshi, Benjamin
AU - Bisland, Stuart
AU - Wood, Thomas J.
AU - Tushinski, Daniel M.
AU - Wilson, David AJ
AU - Kearon, Clive
AU - Cowan, David D.
AU - Khanna, Vickas
AU - Zaki, Amna
AU - Farrell, Janet C.
AU - MacDonald, Anne Marie
AU - Wong, Steven CW
AU - Karbassi, Arsha
AU - Wright, Douglas Steven
AU - Shanthanna, Harsha
AU - Coughlin, Ryan
AU - Khan, Moin
AU - Wikkerink, Spencer
AU - Quraishi, Faraaz A.
AU - Kishta, Waleed
AU - Schemitsch, Emil
AU - Carey, Timothy
AU - Macleod, Mark D.
AU - Sanders, David W.
AU - Vasarhelyi, Edward
AU - Bartley, Debra
AU - Dresser, George K.
AU - Tieszer, Christina
AU - Shadowitz, Steven
AU - Lee, Jacques S.
AU - Choi, Stephen
AU - Kreder, Hans J.
AU - Nousiainen, Markku
AU - Kunz, Monica R.
AU - Tuazon, Ravianne
AU - Shrikumar, Mopina
AU - Ravi, Bheeshma
AU - Wasserstein, David
AU - Stephen, David JG
AU - Nam, Diane
AU - Henry, Patrick DG
AU - Mann, Stephen M.
AU - Jaeger, Melanie T.
AU - Sivilotti, Marco LA
AU - Smith, Christopher A.
AU - Frank, Christopher C.
AU - Grant, Heather
AU - Ploeg, Leone
AU - Yach, Jeff D.
AU - Harrison, Mark M.
AU - Campbell, Aaron R.
AU - Bicknell, Ryan T.
AU - Bardana, Davide D.
AU - McIlquham, Katie
AU - Gallant, Catherine
AU - Halman, Samantha
AU - Thiruganasambandamoorth, Venkatesh
AU - Ruggiero, Sara
AU - Hadden, William J.
AU - Chen, Brian P.J.
AU - Coupal, Stephanie A.
AU - McLean, Lisa M.
AU - Shirali, Hemant R.
AU - Haider, Syed Y.
AU - Smith, Crystal A.
AU - Watts, Evan
AU - Santone, David J.
AU - Koo, Kevin
AU - Yee, Allan J.
AU - Oyenubi, Ademilola N.
AU - Nauth, Aaron
AU - Daniels, Timothy R.
AU - Ward, Sarah E.
AU - Hall, Jeremy A.
AU - Ahn, Henry
AU - Whelan, Daniel B.
AU - Atrey, Amit
AU - Khoshbin, Amir
AU - Puskas, David
AU - Droll, Kurt
AU - Cullinan, Claude
AU - Payendeh, Jubin
AU - Lefrancois, Tina
AU - Mozzon, Lise
AU - Marion, Travis
AU - Jacka, Michael J.
AU - Greene, James
AU - Menon, Matthew
AU - Stiegelmahr, Robert
AU - Dillane, Derek
AU - Irwin, Marleen
AU - Beaupre, Lauren
AU - Coles, Chad P.
AU - Trask, Kelly
AU - MacDonald, Shelley
AU - Trenholm, J. Andrew I.
AU - Oxner, William
AU - Richardson, C. Glen
AU - Dehghan, Niloofar
AU - Sadoughi, Mehdi
AU - Sharma, Achal
AU - White, Neil J.
AU - Olivieri, Loretta
AU - Hunt, Stephen B.
AU - Turgeon, Thomas R.
AU - Bohm, Eric R.
AU - Tran, Sarah
AU - Giilck, Stephen M.
AU - Hupel, Tom
AU - Guy, Pierre
AU - O'Brien, Peter J.
AU - Duncan, Andrew W.
AU - Crawford, Gordon A.
AU - Zhou, Junlin
AU - Zhao, Yanrui
AU - Liu, Yang
AU - Shan, Lei
AU - Wu, Anshi
AU - Muñoz, Juan Manuel
AU - Chaudier, Philippe
AU - Douplat, Marion
AU - Fessy, Michel Henri
AU - Piriou, Vincent
AU - Louboutin, Lucie
AU - David, Jean Stephane
AU - Friggeri, Arnaud
AU - Beroud, Sebastien
AU - Fayet, Jean Marie
AU - Leung, Frankie Ka Li
AU - Fang, Christian Xinshuo
AU - Yee, Dennis King Hang
AU - Sancheti, Parag Kantilal
AU - Pradhan, Chetan Vijay
AU - Patil, Atul Ashok
AU - Puram, Chetan Prabhakar
AU - Borate, Madhav Pandurang
AU - Kudrimoti, Kiran Bhalchandra
AU - Adhye, Bharati Anil
AU - Dongre, Himanshu Vijaykumar
AU - John, Bobby
AU - Abraham, Valsamma
AU - Pandey, Ritesh Arvind
AU - Rajkumar, Arti
AU - George, Preetha Elizabeth
AU - Stephen, Manesh
AU - Chandran, Nitheesh
AU - Ashraf, Mohammed
AU - Georgekutty, A. M.
AU - Sulthan, Ahamad Shaheel
AU - Adinarayanan, S.
AU - Sharma, Deep
AU - Barnawal, Satish Prasad
AU - Swaminathan, Srinivasan
AU - Bidkar, Prasanna Udupi
AU - Mishra, Sandeep Kumar
AU - Menon, Jagdish
AU - M, Niranjan
AU - K, Varghese Zachariah
AU - Hiremath, Santosh Angad
AU - NC, Madhusudhan
AU - Jawali, Abhijit
AU - Gnanadurai, Kingsly Robert
AU - George, Carolin Elizabeth
AU - Maddipati, Tatarao
AU - KP, Mary KP
AU - Sharma, Vijay
AU - Farooque, Kamran
AU - Malhotra, Rajesh
AU - Mittal, Samarth
AU - Sawhney, Chavi
AU - Gupta, Babita
AU - Mathur, Purva
AU - Gamangati, Shivanand
AU - Tripathy, Vijaylaxmi
AU - Menon, Prem Haridas
AU - Dhillon, Mandeep S.
AU - Chouhan, Devendra K.
AU - Patil, Sharanu
AU - Narayan, Ravi
AU - Lal, Purushotham
AU - Bilchod, Prashanth Nabhirajappa
AU - Singh, Surya Udai
AU - Gattu, Uttam Vaidya
AU - Dashputra, Ravi Prabhakar
AU - Rahate, Prashant Vitthal
AU - Turiel, Maurizio
AU - De Blasio, Giuseppe
AU - Accetta, Riccardo
AU - Perazzo, Paolo
AU - Stella, Daniele
AU - Bonadies, Marika
AU - Colombo, Chiara
AU - Fozzato, Stefania
AU - Pino, Fabio
AU - Morelli, Ilaria
AU - Colnaghi, Eleonora
AU - Salini, Vincenzo
AU - Denaro, Giuseppe
AU - Beretta, Luigi
AU - Placella, Giacomo
AU - Giardina, Giuseppe
AU - Binda, Mirko
AU - Marcato, Anna
AU - Guzzetti, Luca
AU - Piccirillo, Fabio
AU - Cecconi, Maurizio
AU - Khor, H. M.
AU - Lai, Hou Yee
AU - Kumar, C. S.
AU - Chee, K. H.
AU - Loh, P. S.
AU - Tan, Kit Mun
AU - Singh, Simmrat
AU - Foo, Li Lian
AU - Prakasam, Komella
AU - Chaw, Sook Hui
AU - Lee, Meng Li
AU - Ngim, Joanne HL
AU - Boon, Huck Wee
AU - Chin, Im Im
AU - Kleinlugtenbelt, Ydo V.
AU - Landman, Ellie BM
AU - Flikweert, Elvira R.
AU - Roerdink, Herbert W.
AU - Brokelman, Roy B.G.
AU - Elskamp-Meijerman, Hannie F.
AU - Horst, Maarten R.
AU - Cobben, Jan Hein MG
AU - Anjum, Anila
AU - Hashmi, Pervaiz Mehmood
AU - Ahmed, Tashfeen
AU - Rashid, Haroon Ur
AU - Khattak, Mujahid Jamil
AU - Rashid, Rizwan Haroon
AU - Lakdawala, Riaz Hussain
AU - Noordin, Shahryar
AU - Juman, Naveed Muhammed
AU - Khan, Robyna Irshad
AU - Riaz, Muhammad Mehmood
AU - Bokhari, Syedah Saira
AU - Almas, Ayesha
AU - Wahab, Hussain
AU - Ali, Arif
AU - Khan, Hammad Naqi
AU - Khan, Eraj Khurshid
AU - Janjua, Kholood Abid
AU - Orakzai, Sajjad Hassan
AU - Khan, Abdus Salam
AU - Mustafa, Khawaja Junaid
AU - Sohail, Mian Amjad
AU - Umar, Muhammad
AU - Khan, Siddra Ahmed
AU - Ashraf, Muhammad
AU - Khan, Muhammad Kashif
AU - Shiraz, Muhammad
AU - Furgan, Ahmad
AU - Dąbek, Piotr
AU - Kumoń, Adam
AU - Satora, Wojciech
AU - Ambroży, Wojciech
AU - Święch, Mariusz
AU - Rycombel, Jacek
AU - Grzelak, Adrian
AU - Gucwa, Jaroslaw
AU - Machala, Waldemar
AU - Ramokgopa, Mmampapatla Thomas
AU - Firth, Gregory Bodley
AU - Karera, Mwalimu
AU - Fourtounas, Maria
AU - Singh, Virsen
AU - Biscardi, Anna
AU - Iqbal, Muhammad Nasir
AU - Campbell, Ryan Jonathan
AU - Maluleke, Matimba Lenny
AU - Moller, Carien
AU - Nhlapo, Lerato
AU - Maqungo, Sithombo
AU - Flint, Margot
AU - Nejthardt, Marcin B.
AU - Chetty, Sean
AU - Naidoo, Rubendren
AU - Garrido Clua, Miriam
AU - Molero-Garcia, Vicente
AU - Minguell-Monyart, Joan
AU - Selga Marsa, Jordi
AU - Porcel-Vazquez, Juan A.
AU - Andres-Peiro, Jose Vicente
AU - Aguilar, Marc
AU - Mestre-Torres, Jaume
AU - Colomina, Maria J.
AU - Guilabert, Patricia
AU - Paños Gozalo, M. Luisa
AU - Abarca, Luis
AU - Martin, Nuria
AU - Usua, Gemma
AU - Martinez-Ripol, Pedro
AU - Gonzalez Posada, M. A.
AU - Lalueza-Broto, Pilar
AU - Sanchez-Raya, Judith
AU - Nuñez Camarena, Jorge
AU - Fraguas-Castany, Antoni
AU - Torner, Pere
AU - Jornet-Gibert, Monsant
AU - Serrano-Sanz, Jorge
AU - Cámara-Cabrera, Jaume
AU - Salomó-Domènech, Mònica
AU - Yela-Verdú, Christian
AU - Peig-Font, Anna
AU - Ricol, Laura
AU - Carreras-Castañer, Anna
AU - Martínez-Sañudo, Luis
AU - Herranz, Susana
AU - Feijoo-Massó, Carlos
AU - Sianes-Gallén, Mònica
AU - Castillón, Pablo
AU - Bernaus, Martí
AU - Quintas, Saioa
AU - Gómez, Olga
AU - Salvador, Jordi
AU - Abarca, Javiera
AU - Estrada, Cristina
AU - Novellas, Marga
AU - Torra, Mercè
AU - Dealbert, Alfred
AU - Macho, Oscar
AU - Ivanov, Alexia
AU - Valldosera, Esther
AU - Arroyo, Marta
AU - Pey, Borja
AU - Yuste, Antoni
AU - Mateo, Llorenç
AU - De Caso, Julio
AU - Anaya, Rafael
AU - Higa-Sansone, J. L.
AU - Millan, Angelica
AU - Baños, Victoria
AU - Herrera-Mateo, Sergio
AU - Aguado, Hector J.
AU - Martinez-Municio, Gonzalo
AU - León, Ricardo
AU - Santiago-Maniega, Silvia
AU - Zabalza, Ana
AU - Labrador, Gregorio
AU - Guerado, Enrique
AU - Cruz, Encarnacion
AU - Cano, Juan Ramon
AU - Bogallo, Jose Manuel
AU - Sa-ngasoongsong, Paphon
AU - Kulachote, Noratep
AU - Sirisreetreerux, Norachart
AU - Pengrung, Nachapan
AU - Chalacheewa, Theerawat
AU - Arnuntasupakul, Vanlapa
AU - Yingchoncharoen, Teerapat
AU - Naratreekoon, Bundit
AU - Kadry, Miriam Adel
AU - Thayaparan, Surendini
AU - Abdlaziz, Ihab
AU - Aframian, Arash
AU - Imbuldeniya, Arjuna
AU - Bentoumi, Souad
AU - Omran, Sherif
AU - Vizcaychipi, Marcela Paola
AU - Correia, Patricia
AU - Patil, Shashank
AU - Haire, Kevin
AU - Mayor, Amy SE
AU - Dillingham, Sally
AU - Nicholson, Laura
AU - Elnaggar, Mohamed
AU - John, Joby
AU - Nanjayan, Shashi Kumar
AU - Parker, Martyn J.
AU - O'Sullivan, Susan
AU - Marmor, Meir T.
AU - Matityahu, Amir
AU - McClellan, Robert Trigg
AU - Comstock, Curt
AU - Ding, Anthony
AU - Toogood, Paul
AU - Slobogean, Gerard
AU - Joseph, Katherine
AU - O'Toole, Robert
AU - Sciadini, Marcus
AU - Ryan, Scott P.
AU - Clark, Molly E.
AU - Cassidy, Charles
AU - Balonov, Konstantin
AU - Bergese, Sergio D.
AU - Phieffer, Laura S.
AU - Gonzalez Zacarias, Alicia A.
AU - Marcantonio, Andrew J.
AU - Dragic-Taylor, Sanela
AU - Maxwell, Chelsea
AU - Molnar, Sarah
AU - Wells, Jennifer R.
AU - Ofori, Sandra N.
AU - Yang, Stephen S.
AU - Wang, Michael K.
AU - Duceppe, Emmanuelle
AU - Spence, Jessica
AU - Vasquez, Javiera P.
AU - Marcano-Fernández, Francesc
AU - Ham, Hyungjoo
AU - Prada, Carlos
AU - Yung, Terence CH
AU - Sanz Pérez, Isidro
AU - Bosch, Michael J.
AU - Prystajecky, Michael R.
AU - Chowdhury, Chinmoy
AU - Khan, James S.
AU - Stella, Steffan F.
AU - Heidary, Behrouz
AU - Tran, Allen
AU - Wawrzycka-Adamczyk, Katarzyna
AU - Chen, Yu Chiao Peter
AU - González-Osuna, Aránzazu
AU - Biedroń, Grzegorz
AU - Wludarczyk, Anna
AU - Lefebvre, Marco
AU - Ernst, Jaclyn A.
AU - Staffhorst, Bas
AU - Woodfine, Jason D.
AU - Alwafi, Emad M.
AU - Mrkobrada, Marko
AU - Parlow, Simon
AU - Roberts, Robin
AU - McAlister, Finlay
AU - Sackett, David
AU - Wright, James
N1 - Publisher Copyright: © 2020 Elsevier Ltd
PY - 2020/2/29
Y1 - 2020/2/29
N2 - Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p<0·0001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0·91 (95% CI 0·72 to 1·14) and absolute risk reduction (ARR) of 1% (−1 to 3; p=0·40). Major complications occurred in 321 (22%) patients assigned to accelerated surgery and 331 (22%) assigned to standard care, with an HR of 0·97 (0·83 to 1·13) and an ARR of 1% (−2 to 4; p=0·71). Interpretation: Among patients with a hip fracture, accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care. Funding: Canadian Institutes of Health Research.
AB - Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p<0·0001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0·91 (95% CI 0·72 to 1·14) and absolute risk reduction (ARR) of 1% (−1 to 3; p=0·40). Major complications occurred in 321 (22%) patients assigned to accelerated surgery and 331 (22%) assigned to standard care, with an HR of 0·97 (0·83 to 1·13) and an ARR of 1% (−2 to 4; p=0·71). Interpretation: Among patients with a hip fracture, accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care. Funding: Canadian Institutes of Health Research.
UR - http://www.scopus.com/inward/record.url?scp=85079855822&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(20)30058-1
DO - 10.1016/S0140-6736(20)30058-1
M3 - Article
C2 - 32050090
AN - SCOPUS:85079855822
SN - 0140-6736
VL - 395
SP - 698
EP - 708
JO - The Lancet
JF - The Lancet
IS - 10225
ER -