Hip-Fracture Surgery on Patients in Clopidogrel Therapy

Hvidovre University Hospital356 enrolled

Overview

Patients in Clopidogrel therapy alone or in combination with acetylsalicylic acid (Dual Antiplatelet Therapy (DAPT) presenting with a hip-fracture represent the surgeon with the dilemma of putting the patient at risk of a major blood loss during and after surgery, or putting the patient at risk of a thromboembolic event after surgery. The investigators hypothesize that the risk of a major blood loss in patients that are still under the effect of Clopidogrel or DAPT during or after hip-fracture surgery is relatively low. The investigators have conducted a retrospective observational study on hip-fracture patients to test this hypothesis.

Study Type

OBSERVATIONAL

Enrollment

356

Conditions

Hip Fracture

Interventions

ClopidogrelDRUG

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * All patients operated with short intramedullary nail for hip-fractures, in the study period. (1st of Jan. 2011-31st of Dec. 2013) Exclusion Criteria: * patients operated \>24 hours after admission, patients in other forms of anticoagulation medication except acetylsalicylic acid (including vitamin K antagonists, dipyridamole, dabigatran, apixaban and rivaroxaban), missing data on blood loss in patient chart, missing blood samples in the first 4 days and extra-national patients (follow up not possible). Patients operated on both sides during the inclusion period were only included with data on their latest operation.

Outcomes

Primary Outcomes

Surgical Blood Loss

Blood loss as assessed by the surgeon

Time frame: at time of surgery

Secondary Outcomes

Total BLood Loss

Calculated based on the method described by Foss et al 2006 (Hidden Blood Loss in hip fractures)

Time frame: From admission to third day after surgery.

Number of transfusions

Number of Red Blood Cell transfusions

Time frame: From admission to third day after surgery

30 and 90 day mortality

Recorded from national persons registry (CPR-registeret)

Time frame: 30 and 90 days postoperatively

Massive transfusion

\>10 Red Blood Cell transfusion within 24 hours of surgery.

Time frame: within 24 hours of surgery

Data from ClinicalTrials.gov

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