Evidence map›Paper›PMID 24276249›Full record

Observational studyJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2014

An evidence-based warfarin management protocol reduces surgical delay in hip fracture patients.

I Ahmed, M A Khan, V Nayak, A Mohsen

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Review
  6. Review
  7. Article
  8. Management of patients with hip fracture receiving anticoagulation: What are we doing in Canada?Canadian journal of surgery. Journal canadien de chirurgie · 2021
    Article
  9. Review
  10. Observational
  11. Observational
  12. Article
  13. Article
  14. CORR InsightsClinical orthopaedics and related research · 2017
    Article
  15. Article
  16. Observational
  17. Article
  18. An evidence-based warfarin management protocol reduces surgical delay in hip fracture patients.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2015
    Article
  19. "Tiers of delay": warfarin, hip fractures, and target-driven care.Geriatric orthopaedic surgery & rehabilitation · 2014
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

I AhmedDepartment of Anaesthesia and Critical Care, Hull Royal Infirmary, Anlaby Road, Kingston upon Hull, HU3 2JZ, UK, driftikhar64@doctors.org.uk.
M A Khan
V Nayak
A Mohsen
Hull Royal Infirmary · GBHull City Council · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUp to 4% of patients presenting with a hip fracture may be on warfarin at admission. There is little consensus on the timing, dosage or route of vitamin K administration. We aimed to evaluate the impact of a locally developed, evidence-based protocol for perioperative warfarin management on the admission-to-operation time (AOT) in hip fracture patients. MATERIALS AND

methodsClinical and demographic data were collected prospectively for hip fracture patients who were on warfarin at the time of admission (post-protocol group) and compared to a historical control group of patients who were on warfarin before implementation of the protocol (pre-protocol group). Univariate analysis was undertaken to identify any significant differences between the two groups.

resultsTwenty-seven patients in the pre-protocol group (27/616, 4.4%) and 40 patients in the post-protocol group (4.7%, 40/855) were on warfarin at admission. There was a significant reduction in the median AOT from 73 h (IQR 46-105) to 37.7 h (IQR 28-45) after implementation of the warfarin protocol (p < 0.001). The proportion of patients operated on within 48 h of admission increased from 30% (8/27) in the pre-protocol group to 80% (32/40) in the post-protocol group (p < 0.001). No significant differences in hospital length of stay (p = 0.77) or the postoperative warfarin recommencement time (p = 0.90) were noted between the two groups.

conclusionImplementation of a perioperative warfarin management protocol can expedite surgery in hip fracture patients, but did not reduce hospital stay in our cohort, possibly because of a delay in recommencing warfarin in these patients postoperatively. LEVEL OF EVIDENCE: Level III.

Indexed as

AgedAged, 80 and overAnticoagulantsAntifibrinolytic AgentsDrug Therapy, CombinationEvidence-Based MedicineFemaleFollow-Up StudiesHip FracturesHumansLength of StayMalePerioperative PeriodProspective StudiesRetrospective StudiesRisk AssessmentAnticoagulantsAntifibrinolytic AgentsVitamin KWarfarin

Identifiers

PMID24276249
PMCPMC3948519
OpenAlexW2003132437

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.