Stress ulcer prophylaxis, thromboprophylaxis and coagulation management in patients with hip fractures

Abstract

Hip fracture in older patients is a major health concern. 20-25 % of hip fracture patients will die in the first year after the trauma (Lane, Clin Orthop Relat Res 471(8):2711, 2013). Postoperative venous thrombosis and gastrointestinal stress-ulcer bleeding are frequent complications with a high case-fatality rate particularly in older patients. Thromboprophylaxis and stress ulcer prophylaxis are important and well established measures to decrease postoperative complications and the mortality rate in this high-risk population.The working group on orthogeriatrics of the Austrian Society on Geriatrics and Gerontology (ÖGGG) is composed of geriatricians who work as trauma surgeons, internists, anaestesists and nurses. A thorough literature search was done, using the terms "orthogeriatrics" and "hip fracture" in combination with "stress ulcer", "gastrointestinal bleeding" and "thrombosis", "thromboprophylaxis". The data was collected, discussed and evaluated in several adjustment meetings of the group and summarized in this article.

Exploring the potential mechanism and molecular targets of Taohong Siwu Decoction against deep vein thrombosis based on network pharmacology and analysis docking

“…[7,8] However, There is ongoing controversy regarding the use of anticoagulation therapy in patients with traumatic stress ulcers, hematological disorders, or cerebral hemorrhage. [9][10][11] Consequently, effectively preventing DVT in long-term bedridden patients without causing new complications remains an urgent issue that requires attention.…”

Higher dose but not low dose proton pump inhibitors are associated with increased risk of subsequent hip fractures after first hip fracture: A nationwide observational cohort study

“…Proton pump inhibitors (PPIs) are acid-suppressive drugs that are prescribed as co-medication particularly to elderly patients to prevent stress ulcers and/or detrimental drug-related side-effects on the gastro-intestinal tract. Also, PPIs are the mainstay for management and prophylaxis of stress ulcers in surgical patients, but there are no guidelines specifically for geriatric hip fracture patients ( Thaler et al, 2013 ). While PPIs are considered as safe medication with which to efficiently treat e.g.…”