Impact of anticoagulants in elderly patients who suffer a hip fracture. Should we have a different approach?

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Tytuł:: Impact of anticoagulants in elderly patients who suffer a hip fracture. Should we have a different approach?
Autorzy:: Lotti F; Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, CABA, Argentina. .
Elizondo CM; Área de investigación en medicina Interna, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, CABA Argentina. .
Barla J; Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, CABA, Argentina; . .
Carabelli G; Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, CABA, Argentina; . .
Soruco ML; Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, CABA, Argentina. .
Boietti BR; Área de investigación en medicina Interna, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, CABA Argentina. .
Benchimol JA; Sección de Geriatría, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, CABA Argentina. .
Źródło:: Acta bio-medica : Atenei Parmensis [Acta Biomed] 2020 Jul 10; Vol. 91 (4), pp. ahead of print. Date of Electronic Publication: 2020 Jul 10.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2003- : Fidenza, Parma : Mattioli 1885
Original Publication: Parma, Italy : Ateneo parmense, [2002]-
MeSH Terms:: Anticoagulants*/adverse effects
Hip Fractures*/surgery
Aged ; Humans ; Length of Stay ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors
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Substance Nomenclature:: 0 (Anticoagulants)
Entry Date(s):: Date Created: 20210202 Date Completed: 20210625 Latest Revision: 20220716
Update Code:: 20240104
PubMed Central ID:: PMC7927563
DOI:: 10.23750/abm.v91i4.8975
PMID:: 33525263
: Czasopismo naukowe

Introduction: Hip fracture in the elderly is a frequent problem. Chronic treatment with anticoagulants is common in these patients, and may delay surgery.
Objectives: To compare time to surgery, hospital stay, in-hospital and 90 days complications between anticoagulated (A) and non-anticoagulated (NA) groups.
Methods: Retrospective cohort of >64 years-old patients with acute hip fracture. Period June-2014 to December 2019. We estimated crude and adjusted OR (95%CI) for in-hospital complications with logistic regression model. We report the crude and adjusted HR for readmission and 90-day mortality with Cox proportional hazards model.
Results: Of the 1058 patients, 123 (11%) were anticoagulated. Time to surgery was 26.4 hours (IIQ 13.9-48) in A and 24 hours (IIQ 2.3-48) in NA, p0.001. Hospital stay was 7 days (IIQ 5-9) in A and 6 days (IIQ 5-10.5) NA, p0,000. In-hospital complications were 17 (14%) in A and 81 (9%) in NA, p0.064. The adjusted OR was 1.53 (95%CI 0.8-2.7) p0.138. For 90-day readmission, the crude HR was 1.51 (95%CI 0.99-2.29) p0.053 and the adjusted HR was 1.31 (95%CI 0.85-2.00) p0,09. For 90-day mortality, the crude HR was 0.80 (95%CI 0.45-1.43) p0.464 and the adjusted HR was 0.70 (95% CI 0.39-1.25) p0.239.
Discussion: While we found differences between groups in time to surgery and hospital statistics, their clinical relevance should be reviewed.

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