Is clopidogrel stopped prior to hip fracture surgery—A survey of current practice in the United Kingdom

Injury ◽  
2007 ◽  
Vol 38 (11) ◽  
pp. 1279-1285 ◽  
Author(s):  
Jeya Palan ◽  
Adekoyejo Odutola ◽  
Simon P. White
2017 ◽  
Vol 11 (1) ◽  
pp. 1190-1199 ◽  
Author(s):  
Hannah Dawe

Hip fracture carries a 30-day mortality of around 8% in the United Kingdom. This figure has remained relatively unchanged despite modern developments in anaesthetic technique. These range from improvements in perioperative analgesia and mortality scoring systems, changes to intra-operative anaesthetic technique and strategies to reduce the requirement for blood transfusion. In this article, we review the current literature on the perioperative management of patients undergoing hip fracture surgery including some of the current controversies.


2020 ◽  
Vol 11 ◽  
pp. 215145932096408
Author(s):  
James T. Berwin ◽  
Hamish Macdonald ◽  
Tom Fleming ◽  
Peter Kempshall ◽  
Daniel Engelke

Introduction: Hip fractures are the most common reason for acute orthopaedic admission in the United Kingdom (UK) and pose a substantial cost to the National Health Service (NHS). A significant proportion of this expenditure is accounted for by hospital bed days, with additional contributions from health and social aftercare. Early ambulation following hip fracture surgery improves outcomes by accelerating functional recovery and reducing the need for ongoing care. The ability to track a patient’s rehabilitation is important in assessing their care needs. While this is challenging to assess accurately, doing so may help to further improve outcomes. The aim of this feasibility study is to determine whether it is possible to accurately measure Mobility After Surgery for Hip fractures (MASH) in the immediate post-operative period by tracking the frequency of mobilization, distance walked and overall activity in the first week following surgery using a wearable activity monitor, the activPAL device. Methods and Materials: A total of 50 patients will be recruited to participate in the study. Ethical approval was given to recruit patients with and without capacity to consent. Immediately after undergoing hip fracture surgery, a activPAL monitor weighing 9 grams and measuring 23.5 mm x 43 x 5 mm in size will be applied to the anterior aspect of the participants thigh with a standard adhesive dressing. We will be assessing the feasibility of using the activPALto measure mobility in this patient group. Discussion: The MASH study will contribute to the design and execution of the MASH trial, which will seek to assess the accuracy by which mobility can be measured following hip fracture surgery and how this information can best be used to improve rehabilitation and care.


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