Evaluation of Clopidogrel Safety in Geriatric Patients with Hip Fracture: A Retrospective Study
| Autor: | Xinbao Wu, Shao-Qiang Zheng, Yuanfang Zheng, Geng Wang, Minghui Yang, Hao Chong, Wenchao Zhang, Yan Zhou |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Arthroplasty Replacement Hip medicine.medical_treatment Blood Loss Surgical Hip fracture Fracture Fixation Internal medicine Humans Internal fixation Orthopedics and Sports Medicine Femur Research Articles Aged Retrospective Studies Femoral neck Aged 80 and over Orthopedic surgery Hip Fractures business.industry Retrospective cohort study medicine.disease Clopidogrel Surgery Discontinuation medicine.anatomical_structure Intraoperative blood loss Hemiarthroplasty business Platelet Aggregation Inhibitors Geriatric RD701-811 Research Article medicine.drug |
| Zdroj: | Orthopaedic Surgery, Vol 13, Iss 6, Pp 1912-1921 (2021) Orthopaedic Surgery |
| ISSN: | 1757-7861 1757-7853 |
| DOI: | 10.1111/os.13143 |
| Popis: | Objective To evaluate the risk of bleeding in elderly patients undergoing early hip fracture surgery with/without clopidogrel administration. Methods This was a retrospective study, and patients over 65 years with fresh hip fracture were enrolled. For the patients taking clopidogrel, early surgical treatment was performed without 5–7 days waiting time. The patients were divided into groups according to their fracture type and the surgical method. Within each fracture/surgery group, the patients were further divided into subgroups according to whether they had clopidogrel administration. The patients' age, gender, American Society of Anesthesiologists (ASA) score, hemoglobin level at admission, and the time from admission to surgery were compared in the different groups. The bleeding outcomes, such as intraoperative blood loss and blood transfusion status, as well as secondary outcomes, such as operation duration and length of hospital stay, were also compared in these groups. Results There were no statistically significant differences in patients' baseline characteristics and outcomes, including intraoperative blood loss, blood transfusion rate, operation duration and length of hospital stay, between the clopidogrel‐administrated patients and the control patients. However, the percentage of patients taking general anesthesia was significantly higher in clopidogrel group than that in control group (P = 0.01). Similar intraoperative blood loss was found in the subgroups of hemi‐hip replacement, internal fixation for intertrochanteric fracture of the femur (fracture type A1‐2, short pin), and internal fixation of femoral neck fracture with cannulated nails. For the internal fixation of femoral neck fracture with cannulated nails, the blood loss is significantly less in both subgroups than that with other two surgical methods. Moreover, the total hip arthroplasty, with the highest bleeding risk among all the surgical methods involved, was rarely chosen to treat geriatric hip fracture in this study. Conclusion This study indicated that compared with patients without clopidogrel administration, elderly patients with hip fractures who receive clopidogrel as long‐term anti‐platelet therapy are relatively safe for surgery in less than 5–7 days after discontinuation of clopidogrel. Our study evaluated the risk of bleeding in elderly patients undergoing early hip fracture surgery with/without clopidogrel administration. Compared with patients without clopidogrel administration, elderly patients with hip fractures who receive clopidogrel as long‐term anti‐platelet therapy are relatively safe for surgery in less than 5–7 days after discontinuation of clopidogrel. |
| Databáze: | OpenAIRE |
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