ArticleInternational orthopaedics2017
A retrospective comparison between delayed and early hip fracture surgery in patients taking clopidogrel: same total bleeding but different timing of blood transfusion.
Article in International orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Effects of pre-operative continuing oral anticoagulants or antiplatelets on health outcomes among older patients with hip fracture: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled 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
- Contemporary cemented versus uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures: a meta-analysis of forty-two thousand forty-six hips.International orthopaedics · 2019Pooled it
- Perioperative Anemia and Transfusion Management in Older Adults with Osteoporotic Hip Fractures: A Narrative Review of Current Evidence and Emerging Strategies.Clinical interventions in aging · 2026Review
- Factors influencing hip fracture surgery after two days of hospitalization using a national administrative database.Scientific reports · 2024Article
- Does the Surgical Approach Influence Bleeding in Hip Fracture Patients Taking Clopidogrel?Cureus · 2023Article
- Quality of Life and Post-Surgical Complications in Patients on Chronic Antiplatelet Therapy with Proximal Femur Fracture: 12-Month Follow-Up after Implementing a Strategy to Shorten the Time to Surgery.Journal of clinical medicine · 2023Article
- 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
- The Risk of Bleeding and Adverse Events with Clopidogrel in Elective Hip and Knee Arthroplasty Patients.Journal of clinical medicine · 2022Article
- Association between osteoporosis or osteopenia and taking antiplatelet agents in general US population of NHANES.Frontiers in endocrinology · 2022Article
- The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition.Critical care (London, England) · 2019Article
- Reasons for delaying surgery following hip fractures and its impact on one year mortality.International orthopaedics · 2019Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeManaging hip fracture surgery in patients taking clopidogrel is challenging. The optimal timing for surgery remains unclear. Early surgery in such patients potentially increases peri-operative bleeding, whereas delayed surgery has been shown to be associated with worse postoperative outcomes. The aim of this study was to investigate whether a delay to surgery affects total blood loss, bleeding kinetics, blood transfusion requirements, or post-operative outcomes.
methodsA retrospective monocentric study including all hip fracture patients treated with clopidogrel between 2011 and 2016 (39 patients) was carried out. Patients who underwent delayed surgery after withholding clopidogrel for five days or more, from 2011 to 2013, were compared to patients who benefited from earlier surgical procedures (within 48 hours of admission) from 2014 to 2016.
resultsTotal blood loss, amount of blood transfusion and rate of postoperative complications did not differ between the two groups. However, the timing of bleeding was significantly different; blood loss occurred during the pre-operative phase in the delayed surgery group (p < 0.0001), whereas it occurred during the intra-operative phase in the early surgery group (p = 0.005). The length of the hospital stay was significantly shorter for the early surgery group than for the delayed surgery group: 11 ± three versus 15 ± four days (p = 0.004).
conclusionsEarly surgical treatment of hip fracture in patients receiving clopidogrel does not increase the overall red blood cell loss or the transfusion requirement, but may affect the timing of blood transfusion. Hip fracture surgery should preferably be performed without delay in patients taking clopidogrel.
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