- Title
- Dual antiplatelet therapy and surgical timing in geriatric hip fracture
- Creator
- Tarrant, Seth M.; Kim, Raymond G.; McGregor, Kassandra L.; Palazzi, Kerrin; Attia, John; Balogh, Zsolt J.
- Relation
- Journal of Orthopaedic Trauma Vol. 34, Issue 10, p. 559-565
- Publisher Link
- http://dx.doi.org/10.1097/BOT.0000000000001779
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2020
- Description
- Objective: To determine how timing of surgery affects transfusion, major complications, and mortality in patients who sustain a geriatric hip fracture while taking dual antiplatelet therapy (DAPT; typically aspirin and clopidogrel). Design: Retrospective cohort study. Setting: University-affiliated Level 1 Trauma Center. Patients: Patients 65 years of age or older on DAPT with a geriatric hip fracture were investigated at a single institution between 2002 and 2017. Demographic and perioperative data were collected from patient records, institutional databases, and national hip fracture registry. Intervention: Fixation or arthroplasty. Main Outcome Measurement: Transfusion, major complications, and 30-day mortality. Results: Of the 6724 patients sustaining a geriatric hip fracture, 122 patients were taking DAPT on admission. Timing of surgery did not influence transfused units (incidence rate ratio 1.00, 95% confidence interval: 0.87-1.15, P = 0.968) but did affect major complications (time modeled as quadratic term; odds ratios ranging from 0.20 to 7.91, Ptime = 0.001, Ptime*time<0.001) and 30-day mortality (odds ratio 1.32, 95% confidence interval: 1.03-1.68, P = 0.030). Conclusion: Surgical delay does not change the need for transfusion of hip fracture patients on DAPT, but it is associated with increased probabilities of major complications and 30-day mortality. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subject
- hip fracture; antithrombotics; antiplatelets; CoPlavix; mortality
- Identifier
- http://hdl.handle.net/1959.13/1454897
- Identifier
- uon:45019
- Identifier
- ISSN:1531-2291
- Language
- eng
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