Chronic Warfarin Anticoagulation in Hip Fracture Patients Delays Surgery and Is Associated With Increased Risk of Postoperative Complications: A Multicenter Propensity-Score–Matched Analysis

Levack, Ashley E.; Moore, Harold E.; Stephan, Stephen; Jo, Sally; Schroeder, Ian; Garlich, John; Hadad, Aidan; Little, Milton T. M.; Miller, Anna N.; Lyman, Stephen; Lane, Joseph M.

doi:10.1097/bot.0000000000002484

Cited by 5 publications

(1 citation statement)

References 34 publications

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“…In an article published in 2023 by Levack et al, 55 years or older proximal femoral fractured patients were evaluated, of which, 210 patients were undergoing warfarin therapy and 420 patients served as the matched control cohorts. The study revealed those patients treated with warfarin increasingly experienced delayed surgery and a greater number of postoperative complications when compared to matched controls without warfarin therapy (12).…”

Section: Discussionmentioning

confidence: 99%

Chronic anticoagulation therapy and acute hip trauma

Becken,

Ayerh,

Mester

et al. 2024

MTO

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Regardless of the association between hip fracture surgery and mortality, morbidity and bleeding risks, there are still significant contradictions in various published articles concerning hip fracture surgery outcomes when patients are prescribed anticoagulant medication. The primary objective of this study was to investigate if patients prescribed anticoagulants experienced delayed surgery when compared to non-users. The secondary goal was to investigate if patients prescribed anticoagulants underwent an extended hospital stay and complications such as increased bleeding, mortality and a higher rate of comorbidities when compared to non-users. Data from proximal hip fracture patients were prospectively collected at a level I university trauma center. From 1 January, 2020, through 1 January, 2021, 519 eligible patients were identified. Anticoagulant medication upon admission, time prior to surgery, hospitalized days, 30-day mortality rates, 1-year mortality, blood transfusion requirement and various comorbidities were noted. 222 of the 519 hip fracture patients were prescribed anticoagulants. Of the 222 patients, 75% were females and 25% were males. In total, 46% required a blood transfusion, with no significant differences between the anticoagulated and non-anticoagulated patients. 50% of the anticoagulated group and 42% of the control group required perioperative blood transfusion. Neither the 30-day nor the 1-year mortality rate showed statistically significant differences between the groups. However, the time to surgery and the length of hospital stay was significantly longer in the anticoagulated group. Comorbidities were found in 87% of the patients: in 95% of the anticoagulated group and in 81% of the non-anticoagulated group. Patients prescribed anticoagulants at the time of hip fracture experienced delayed surgery, longer hospital stays and more comorbidities when compared to patients not on anticoagulants. Neither a blood transfusion requirement, 30-day mortality rate nor a 1-year mortality rate showed no significant difference between the two cohorts.

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Section: Discussionmentioning

confidence: 99%