PMID- 34395048
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220425
IS  - 2151-4585 (Print)
IS  - 2151-4593 (Electronic)
IS  - 2151-4585 (Linking)
VI  - 12
DP  - 2021
TI  - Antithrombotics in Patients With a Femoral Neck Fracture: Evaluating Daily 
      Practice in an Observational Cohort Study.
PG  - 21514593211037755
LID - 10.1177/21514593211037755 [doi]
LID - 21514593211037755
AB  - INTRODUCTION: Geriatric hip fracture patients are characterized by frailty due to 
      multiple comorbidities, such as cardiovascular disease, in which the use of 
      antithrombotics is frequent. The aim of this study is to assess the effect of 
      antithrombotics on perioperative care and patient outcomes after hip 
      hemiarthroplasty following current guidelines. MATERIALS AND METHODS: This 
      observational cohort study included all consecutively admitted patients with a 
      femoral neck fracture requiring hip hemiarthroplasty between January 1(st) 2010, 
      and May 16(th) 2016, in two level II trauma teaching hospitals. Patients with 
      multiple trauma injuries were excluded. RESULTS: In total, n = 907 patients (68% 
      female (n = 615), median age 84 years) were included of which n = 142 used a 
      vitamin K antagonist (VKA) and n = 213 used antiplatelet (AP) therapy. Both were 
      associated with more packed cell supplementation (.4 +/- 1.1 units and .3 +/- .8 
      units vs .2 +/- .6 units, P < .001 and P = .03, respectively). VKA was associated 
      with more hematomas compared no antithrombotics (23% vs 11%, P = .001). VKA had a 
      longer time to surgery compared to no antithrombotics and AP (24 hours vs 19 and 
      20 hours, P < .001 and P < .001, respectively) and longer admission duration 
      (9 days vs 7 days P < .001. There were no differences in 30 day mortality nor in 
      1-year mortality rates. DISCUSSION: All modifiable causes for deep SSI, such as 
      hematomas, should be prevented in acute hip fracture surgery. Since 
      antithrombotics are associated with hematomas, an optimal handling in 
      perioperative setting is necessary. CONCLUSION: VKA was associated with longer 
      time to surgery, more hematomas, and longer admission duration. VKA and AP were 
      associated with more packed cell supplementation.
CI  - (c) The Author(s) 2021.
FAU - van Rijckevorsel, Veronique A J I M
AU  - van Rijckevorsel VAJIM
AUID- ORCID: 0000-0001-5628-6907
AD  - Surgery Department, Maasstad Hospital, Rotterdam, the Netherlands. RINGGOLD: 7000
FAU - Roukema, Gert R
AU  - Roukema GR
AD  - Surgery Department, Maasstad Hospital, Rotterdam, the Netherlands. RINGGOLD: 7000
FAU - Klem, Taco M A L
AU  - Klem TMAL
AD  - Surgery Department, Franciscus Hospital, Rotterdam, the Netherlands.
FAU - Kuijper, Tjallingius M
AU  - Kuijper TM
AD  - Science Board, Maasstad Hospital, Rotterdam, the Netherlands. RINGGOLD: 7000
FAU - de Jong, Louis
AU  - de Jong L
AUID- ORCID: 0000-0002-4085-6861
AD  - Surgery Department, Franciscus Hospital, Rotterdam, the Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20210811
PL  - United States
TA  - Geriatr Orthop Surg Rehabil
JT  - Geriatric orthopaedic surgery & rehabilitation
JID - 101558150
PMC - PMC8361536
OTO - NOTNLM
OT  - anticoagulation
OT  - antiplatelet therapy
OT  - clinical outcomes
OT  - hip fracture
OT  - hip hemiarthroplasty (HA)
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/08/17 06:00
MHDA- 2021/08/17 06:01
PMCR- 2021/08/11
CRDT- 2021/08/16 05:58
PHST- 2021/04/12 00:00 [received]
PHST- 2021/07/07 00:00 [revised]
PHST- 2021/07/19 00:00 [accepted]
PHST- 2021/08/16 05:58 [entrez]
PHST- 2021/08/17 06:00 [pubmed]
PHST- 2021/08/17 06:01 [medline]
PHST- 2021/08/11 00:00 [pmc-release]
AID - 10.1177_21514593211037755 [pii]
AID - 10.1177/21514593211037755 [doi]
PST - epublish
SO  - Geriatr Orthop Surg Rehabil. 2021 Aug 11;12:21514593211037755. doi: 
      10.1177/21514593211037755. eCollection 2021.