Dual Antiplatelet Therapy and Surgical Timing in Geriatric Hip Fracture
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
|---|---|
| Enthalten in: |
Journal of orthopaedic trauma - 34(2020), 10 vom: 01. Okt., Seite 559-565 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Tarrant, Seth M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 21.06.2021 Date Revised 21.06.2021 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1097/BOT.0000000000001779 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM308892763 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM308892763 | ||
| 003 | DE-627 | ||
| 005 | 20231225132721.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/BOT.0000000000001779 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1029.xml |
| 035 | |a (DE-627)NLM308892763 | ||
| 035 | |a (NLM)32304474 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Tarrant, Seth M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Dual Antiplatelet Therapy and Surgical Timing in Geriatric Hip Fracture |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.06.2021 | ||
| 500 | |a Date Revised 21.06.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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) | ||
| 520 | |a DESIGN: Retrospective cohort study | ||
| 520 | |a SETTING: University-affiliated Level 1 Trauma Center | ||
| 520 | |a 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 | ||
| 520 | |a INTERVENTION: Fixation or arthroplasty | ||
| 520 | |a MAIN OUTCOME MEASUREMENT: Transfusion, major complications, and 30-day mortality | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Platelet Aggregation Inhibitors |2 NLM | |
| 700 | 1 | |a Kim, Raymond G |e verfasserin |4 aut | |
| 700 | 1 | |a McGregor, Kassandra L |e verfasserin |4 aut | |
| 700 | 1 | |a Palazzi, Kerrin |e verfasserin |4 aut | |
| 700 | 1 | |a Attia, John |e verfasserin |4 aut | |
| 700 | 1 | |a Balogh, Zsolt J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of orthopaedic trauma |d 1996 |g 34(2020), 10 vom: 01. Okt., Seite 559-565 |w (DE-627)NLM012994979 |x 1531-2291 |7 nnns |
| 773 | 1 | 8 | |g volume:34 |g year:2020 |g number:10 |g day:01 |g month:10 |g pages:559-565 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/BOT.0000000000001779 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 34 |j 2020 |e 10 |b 01 |c 10 |h 559-565 | ||