Observational studyJournal of orthopaedic surgery and research2019
The impact of warfarin on operative delay and 1-year mortality in elderly patients with hip fracture: a retrospective observational study.
Observational study in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Synthesis of the evidence on the impact of pre-operative direct oral anticoagulants on patient health outcomes after hip fracture surgery: rapid systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- The use of short cementless femoral stems in total hip arthroplasty for femoral neck fractures: a scoping review of the literature.Musculoskeletal surgery · 2026Article
- Construction and validation of a predictive model for the risk of prolonged preoperative waiting time in patients with intertrochanteric fractures.Frontiers in medicine · 2024Article
- Predictive value of tip-apex distance and calcar-referenced tip-apex distance for cut-out in 398 femoral intertrochanteric fractures treated in a private practice with dynamic intramedullary nailing.Frontiers in surgery · 2024Article
- The Effect of Pre-operative use of Antiplatelets and Anticoagulants on Time to Surgery in Hip Fracture Patients.Malaysian orthopaedic journal · 2023Article
- The Effect of Warfarin Use on Postoperative Outcomes after Femoral Neck Surgery.Journal of clinical medicine · 2023Article
- Do anticoagulants impact the "in-house mortality" after surgical treatment of proximal femoral fractures-a multivariate analysis.International orthopaedics · 2022Article
- Risk factors of mortality and second fracture after elderly hip fracture surgery in Shanghai, China.Journal of bone and mineral metabolism · 2022Article
- Proximal femur fractures in patients taking anti-coagulants: has anything changed?EFORT open reviews · 2022Review
- New tip-apex distance and calcar-referenced tip-apex distance cut-offs may be the best predictors for cut-out risk after intramedullary fixation of proximal femur fractures.Scientific reports · 2022Observational
- Time to Surgery and Outcome in the Treatment of Proximal Femoral Fractures.Deutsches Arzteblatt international · 2021Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGuidelines underline the importance of early surgery in elderly patients with proximal femoral fractures. However, most of these patients present a high number of comorbidities, some of which require the use of warfarin. Waiting for INR decrease is a cause of surgical delay, and this influences negatively their outcome.
methodsWe retrospectively reviewed all patients with proximal femoral fracture admitted to our unit from March 2013 to March 2017 to determine whether warfarin therapy is associated with reduction of survival, delay of surgery, and increased blood loss. From 1706 patient, a total of 1292 fulfilled the eligibility criteria and were included. Data regarding general information (type of fracture according to AO/OTA classification), pharmacological history regarding anticoagulant therapy pre-admission, surgery (type of surgery and time to surgery), clinical findings (blood loss), and date of exitus were collected.
resultsWe identified 157 patients with warfarin, 442 with antiplatelet agents (aspirin, clopidogrel, ticlopidin), and 693 in the control group. We observed a significant difference in the warfarin group regarding an increased ASA score, Charlson Comorbidity Index, and blood loss. Patients taking warfarin experience delay to the theater significantly more than the other groups. Patients in warfarin therapy have a 42% higher risk of death within 1 year from their surgery. Patients who underwent surgery after 48 h have 1.5 times higher risk of mortality with respect to the patients who underwent surgery within 48 h.
conclusionWarfarin therapy at the time of proximal femoral fractures is associated with increased time to surgery, blood loss, and mortality.
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