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Study finds no cause for delaying hip fracture surgery in patients receiving antiplatelet drugs
Thein, R. Injury. 2011. doi:10.1016/j.injury.2011.01.011
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A study of blood loss and surgery-related complications found that hip fracture surgery need not be delayed because patients are receiving antiplatelet drugs.
“Notably, delay of surgical intervention for hip fracture repair for >48 hours has been reported to increase perioperative complications and mortality,” the authors wrote.
Researchers measured intra- and perioperative blood loss, the volume of transfused blood and surgery-related complications in two groups. One group of 44 patients received continuous clopidogrel treatment while the other 44-patient control group was not on clopidogrel (either aspirin alone or not on any antiplatelets).
The team reported mean perioperative blood loss of 899 ± 496 ml for patients not on clopidogrel, 1091 ± 654 ml for those on clopidogrel and 1312 ± 686 ml for those on combined clopidogrel and aspirin. No cases of mortality were reported in the early postoperative period. A shorter time to operation and prolonged surgical time were associated with increased blood loss.
Although the researchers noted that the antiplatelet effect ceases in nearly 10 days, “their (antiplatelet drugs) effect on surgery-related blood loss and perioperative complications is unclear and management of trauma patients treated by antiplatelets is controversial.”