Abstract Number: PB0278
Meeting: ISTH 2020 Congress
Background: Hip fractures are a major cause of morbidity and mortality in elderly population with one-year mortality rates up to 20%. Delayed surgery (beyond 48 hours) is a major predictor of the many factors that are associated with worse prognosis following hip fracture surgery (HFS). The use of anti-platelet therapy (APT) may potentially lead to excessive bleeding and is associated with surgical delay and in one large hip fracture patient cohort APT was the direct cause of HFS delay in 17% of patients.
Aims: To study the association between use of pre-surgery treatment with APT on time to HFS in elderly patients.
Methods: A retrospective study on consecutive patients with hip fractures aged ≥ 65 years of age admitted and operated at the Ortho-Geriatric department at Sheba Medical Center between 2014-2018. Admission and surgery times as well as demographic, co-morbidity, mortality and adverse event data were extracted from electronic patient files and time to surgery (TTS) and rates of delayed surgery were compared between APT treated vs. control patients (no APT or anticoagulant treatment).
Results: One thousand and thirty patients were studied, of which 370 (35.9%) patients were taking APT (mainly single APT, SAPT) while 36 were taking dual APT (DAPT). Most patients took low dose aspirin (326) while Plavix was used in 80 patients. Most patients (325/327) continued aspirin treatment whereas Plavix was stopped after admission in all patients. Median TTS was not different between groups (23.5 hours, 26.4 hours and 28.9 hours in controls and in SAPT and DAPT patients, respectively, P= 0.624). Similarly % patients operated beyond 48 hours was not different (14.9%, 13.9% and 20.0% in controls and in SAPT and DAPT patients, respectively, P= 0.101).
Conclusions: Elderly APT treated patients suffering a hip fracture underwent HFS at a similar time frame and similar TTS compared to non-treated control patients.
To cite this abstract in AMA style:Lubetsky A, Seltser A. Delay in Time to Hip Fracture Repair Surgery among Elderly Patients Treated with Anti Platelet Therapy [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/delay-in-time-to-hip-fracture-repair-surgery-among-elderly-patients-treated-with-anti-platelet-therapy/. Accessed November 30, 2021.
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