ArticleAnnals of the Royal College of Surgeons of England2016
Decision making on timing of surgery for hip fracture patients on clopidogrel.
Article in Annals of the Royal College of Surgeons of England, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is hip fracture surgery safe for patients on antiplatelet drugs and is it necessary to delay surgery? A systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2020Pooled it
- The Perioperative Management of Antiplatelet and Anticoagulant Drugs in Hip Fractures: Do the Surgery as Early as Possible.The archives of bone and joint surgery · 2022Review
- Orthogeriatric co-management for the care of older subjects with hip fracture: recommendations from an Italian intersociety consensus.Aging clinical and experimental research · 2021Review
- Evaluation of Clopidogrel Safety in Geriatric Patients with Hip Fracture: A Retrospective Study.Orthopaedic surgery · 2021Article
- Proximal femur fractures in patients taking anticoagulants.EFORT open reviews · 2020Review
- The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition.Critical care (London, England) · 2019Article
- Optimized clinical practice for superaged patients with hip fracture: significance of damage control and enhanced recovery program.Burns & trauma · 2019Review
- Surgical Technical Evidence Review of Hip Fracture Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.Geriatric orthopaedic surgery & rehabilitation · 2018Review
- A retrospective comparison between delayed and early hip fracture surgery in patients taking clopidogrel: same total bleeding but different timing of blood transfusion.International orthopaedics · 2017Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients taking clopidogrel who sustain a fractured neck of femur pose a challenge to orthopaedic surgeons. The aim of this study was to determine whether delay to theatre for these patients affects drop in haemoglobin levels, need for blood transfusion, length of hospital stay and 30-day mortality. A retrospective review of all neck of femur patients admitted at two centres in the North East of England over 3 years revealed 85 patients. Patients were divided into two groups depending on whether they were taking clopidogrel alone (C) or with aspirin (CA). Haemoglobin drop was significantly different in the CA group that was operated on early (CA1) versus the group for which surgery was delayed by over 48 hours (CA2): 3.3g/dl and 1.9g/dl respectively (p=0.01). The mean inpatient stay in group C was 35.9 days while in group CA it was 19.9 days (p=0.002). The mean length of stay in group CA2 (26.7 days) was significantly longer than for CA1 patients (14.1 days) (p=0.01). There were no significant differences in mortality or wound complications. Hip fracture patients on clopidogrel can be safely operated on early provided they are medically stable. Bleeding risk should be borne in mind in those patients on dual therapy with aspirin.
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