Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery.
Autor: | Gonzalez CA; From the Reno School of Medicine, University of Nevada, Reno, NV (Dr. Gonzalez); the Department of Orthopaedic Surgery, Stanford University, Stanford, CA (Dr. Rysselberghe and Dr. Gardner); and the University of Illinois College of Medicine, Chicago, IL (Dr. Maschhoff)., Van Rysselberghe NL, Maschhoff C, Gardner MJ |
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Jazyk: | angličtina |
Zdroj: | Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews [J Am Acad Orthop Surg Glob Res Rev] 2024 Apr 09; Vol. 8 (4). Date of Electronic Publication: 2024 Apr 09 (Print Publication: 2024). |
DOI: | e23.00159 |
Abstrakt: | Introduction: Low platelet counts have clinically relevant effects on patient outcomes after hip fracture surgery; however, the relationship between abnormally high platelet counts and postoperative outcomes in this population is unknown. Methods: The ACS-NSQIP database was queried for patients who underwent hip fracture surgery between 2015 and 2019. Outcomes were compared between patients with normal platelet counts (150,000 to 450,000/μL) and thrombocytosis (>450,000/μL). Results: Eighty-six thousand three hundred eleven hip fracture patients were identified, of which 1067 (1.2%) had preoperative thrombocytosis. Compared with patients with normal platelet counts, patients with preoperative thrombocytosis had increased rates of 30-day mortality (6.4% vs 4.5%, P = 0.004; OR 1.15 [95% CI 0.88 to 1.50], P = 0.322) as well as increased rates and odds of readmission (11.4% vs 7.8%, P < 0.001; OR 1.35 [95% CI 1.10 to 1.65], P = 0.004) and venous thromboembolic events (3.2% vs 1.7%, P < 0.001; OR 1.88 [95% CI 1.31 to 2.71], P < 0.001). Conclusions: Hip fracture patients with preoperative thrombocytosis had increased rates of early mortality as well as increased odds of venous thromboembolic events and readmission. A patient with thrombocytosis may benefit from close postoperative surveillance and careful follow-up. Future prospective studies are needed to verify causation and investigate how to mitigate adverse outcomes in hip fracture patients with preoperative thrombocytosis. Competing Interests: All authors declare that they have no conflicts of interest. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.) |
Databáze: | MEDLINE |
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