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- Title
Safety of urgent surgery for the patients with proximal femur fracture treated with platelet aggregation inhibitors: a propensity-score matching analysis.
- Authors
Kim, Chul-Ho; Chang, Jae Suk; Lim, Yaeji; Lim, Dongkyung; Kim, Ji Wan
- Abstract
Introduction: To compare the various perioperative outcomes in an urgent surgery setting among patients with proximal femur fracture (PFF) who received platelet aggregation inhibitors (PAIs) and those who did not. Methods: We retrospectively reviewed the data of 1,838 patients who underwent surgery for PFF between January 2011 and January 2021. We conducted 1:1 propensity-score matching and compared the perioperative outcomes, including operation time, postoperative complications, hospital stay, mortality, and variables related to bleeding risk (e.g., number of transfusion profiles, hemoglobin levels, and laboratory data, including coagulation battery). Results: Of the 492 patients who were treated with PAIs, 484 were 1:1 matched to the untreated control group. The PAI group showed shorter operation time than the matched control group (72.3 min for PAI vs. 77.7 min for control; P = 0.041), and the control group showed more pulmonary thromboembolism (0.2% for PAI vs 1.7% for control; P = 0.046) than the PAI group. The other complications and length of hospital stay, mortality rate, transfusion profile, and the laboratory test (except preoperative international normalized ratio, INR) showed no significant difference between the groups. Subgroup analyses of the patients treated with only aspirin (aspirin: 306, matched control: 306), only clopidogrel (clopidogrel: 100, matched control: 100), and others who were treated with dual anticoagulation (dual anticoagulation: 78, matched control: 78) showed no significant differences in perioperative outcomes among the groups. Conclusion: The patients who were treated with PAI could undergo PFF surgery safely without delay, which led to no significant difference in operation time, postoperative complication risk, perioperative blood transfusion, and variables related to bleeding risk. Therefore, we believe that it is unnecessary to delay surgery for patients with PFF who receive PAI.
- Subjects
HEMORRHAGE risk factors; THROMBOEMBOLISM risk factors; HIP surgery; PULMONARY embolism; ANTICOAGULANTS; SURGERY; PATIENTS; ASPIRIN; TREATMENT effectiveness; RETROSPECTIVE studies; SURGICAL blood loss; TREATMENT duration; DESCRIPTIVE statistics; SURGICAL complications; PROXIMAL femoral fractures; MEDICAL records; ACQUISITION of data; CASE-control method; INTERNATIONAL normalized ratio; CLOPIDOGREL; PLATELET aggregation inhibitors; COMPARATIVE studies; LENGTH of stay in hospitals; BLOOD transfusion; EVALUATION; DISEASE risk factors
- Publication
European Journal of Trauma & Emergency Surgery, 2024, Vol 50, Issue 2, p347
- ISSN
1863-9933
- Publication type
Article
- DOI
10.1007/s00068-023-02368-9