Merete Gregersen

Do anticoagulants affect outcomes of hip fracture surgery? A cross-sectional analysis

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Caroline Hoerlyck
  • ,
  • Terence Ong, Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK. terenceong@doctors.org.uk.
  • ,
  • Merete Gregersen
  • Else Marie Damsgaard
  • Lars Borris
  • ,
  • Jac Kie Chia, Department for Healthcare of Older People, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
  • ,
  • Ying Yi Wendy Yap, Department for Healthcare of Older People, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
  • ,
  • Namal Weerasuriya, Department for Healthcare of Older People, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
  • ,
  • Opinder Sahota, Department for Healthcare of Older People, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.

INTRODUCTION: The management of patients with a hip fracture is affected by the use of oral anticoagulants. A cross-sectional analysis was undertaken to investigate health outcome differences in those anticoagulated compared to those not anticoagulated.

METHODS: Patients aged 50 years and over presenting to a large university hospital with hip fractures were identified from the service registry. Patient characteristics and health outcomes between those not anticoagulated were compared with those anticoagulated (warfarin and direct oral anticoagulants, DOAC).

RESULTS: 200/2307 (9%) patients were anticoagulated. 84% were on warfarin, and the rest a DOAC. Compared to those anticoagulated, there was a higher prevalence of dementia (25% vs. 18%, p = 0.02) and a lower prevalence of cardiovascular disease (54% vs. 78%, p < 0.01), atrial fibrillation (10% vs. 82%, p < 0.01), and polypharmacy (55% vs. 76%, p < 0.01). Renal function was lower in the anticoagulated group. Time to operation for those not anticoagulated and anticoagulated was a median (IQR) of 25 (15) and 27 (18) hours. There was no difference in blood transfusion and hospital mortality. Postoperative complications were similar except a higher rate of renal failure (14% vs. 19%, p = 0.04) and heart failure (1% vs. 5%, p < 0.01), and a longer length of stay [median (IQR): 14 (10) vs. 16 (12) days] in the anticoagulated group. This was no longer significant after adjustment of confounders.

CONCLUSION: There was no statistically significant difference in health outcomes between those anticoagulated and those not after adjusting for patient characteristics. It was feasible to avoid significant delay in hip fracture surgery in those anticoagulated.

OriginalsprogEngelsk
TidsskriftArchives of Orthopaedic and Trauma Surgery
Vol/bind140
Nummer2
Sider (fra-til)171-176
Antal sider6
ISSN0936-8051
DOI
StatusUdgivet - feb. 2020

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