scholarly journals Antithrombotics in Patients With a Femoral Neck Fracture: Evaluating Daily Practice in an Observational Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932110377
Author(s):  
Veronique A. J. I. M. van Rijckevorsel ◽  
Gert R. Roukema ◽  
Taco M. A. L. Klem ◽  
Tjallingius M. Kuijper ◽  
Louis de Jong
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Observational Cohort Study ◽  
Total N ◽  
Hip Hemiarthroplasty ◽  
Time To Surgery ◽  
Neck Fracture ◽  
Observational Cohort

Introduction Geriatric hip fracture patients are characterized by frailty due to multiple comorbidities, such as cardiovascular disease, in which the use of antithrombotics is frequent. The aim of this study is to assess the effect of antithrombotics on perioperative care and patient outcomes after hip hemiarthroplasty following current guidelines. Materials and Methods This observational cohort study included all consecutively admitted patients with a femoral neck fracture requiring hip hemiarthroplasty between January 1st 2010, and May 16th 2016, in two level II trauma teaching hospitals. Patients with multiple trauma injuries were excluded. Results In total, n = 907 patients (68% female (n = 615), median age 84 years) were included of which n = 142 used a vitamin K antagonist (VKA) and n = 213 used antiplatelet (AP) therapy. Both were associated with more packed cell supplementation (.4 ± 1.1 units and .3 ± .8 units vs .2 ± .6 units, P < .001 and P = .03, respectively). VKA was associated with more hematomas compared no antithrombotics (23% vs 11%, P = .001). VKA had a longer time to surgery compared to no antithrombotics and AP (24 hours vs 19 and 20 hours, P < .001 and P < .001, respectively) and longer admission duration (9 days vs 7 days P < .001. There were no differences in 30 day mortality nor in 1-year mortality rates. Discussion All modifiable causes for deep SSI, such as hematomas, should be prevented in acute hip fracture surgery. Since antithrombotics are associated with hematomas, an optimal handling in perioperative setting is necessary. Conclusion VKA was associated with longer time to surgery, more hematomas, and longer admission duration. VKA and AP were associated with more packed cell supplementation.

scholarly journals Anticoagulation in Patients With a Femoral Neck Fracture: Evaluating Daily Practice.

2020 ◽  
Author(s):  
Veronique A.J.I.M. van Rijckevorsel ◽  
Louis de Jong ◽  
Taco M.A.L. Klem ◽  
Tjallingius M. Kuijper ◽  
Gert R. Roukema
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Antiplatelet Therapy ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Daily Practice ◽  
Hip Hemiarthroplasty ◽  
Time To Surgery ◽  
Neck Fracture

Abstract Background: Geriatric hip fracture patients are fragile and mostly suffering from multiple comorbidities, such as cognitive or cardiovascular disease, in which the use of antiplatelet therapy or vitamin K antagonists is common. The aim of this study is to assess the effect of antiplatelet therapy and vitamin K antagonists on perioperative care and patient outcome after hip hemiarthroplasty in daily practice.Methods: Patients with a femoral neck fracture requiring hip hemiarthroplasty were included in the study. Data were extracted from a prospective hip fracture database and completed by retrospective review of the hospital records at two level II trauma centers between January 1st 2010 and May 16th 2016. Results: 907 patients (68% female) were included, with a median age of 84 (IQR 78-88), of which 415 (46%) used any sort of anticoagulation. Anticoagulation medication was associated with more packed cell supplementation; 0.33 units (±0.88) vs. 0.15 units (±0.61) (P=<0.001). Also, more hematoma’s were found for patients with anticoagulation, 19.5% versus 11.4%, P= 0.001. Patients using vitamin K antagonists needed more days to be ready for discharge compared to patients without anticoagulation, 5.5 days (4-9) versus 4 days (3-7), P = < 0.001.There was no significant difference in 30-day or 1-year mortality after surgery, nor in time to surgery. Conclusion: Patients using any sort of anticoagulation are in need of more packed cell supplementation, develop more hematomas and need more days to be ready for discharge, compared to patients without anticoagulation use. Also prolonged time to surgery was found for patients using vitamin K antagonists.

scholarly journals Surgical site infection after hip fracture – mortality and risk factors: an observational cohort study of 1,709 patients

2020 ◽  
Vol 91 (3) ◽  
pp. 347-352 ◽  
Author(s):  
Christian T Pollmann ◽  
Fredrik A Dahl ◽  
Jan Harald M Røtterud ◽  
Jan-Erik Gjertsen ◽  
Asbjørn Årøen
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hip Fracture ◽  
Surgical Site Infection ◽  
Observational Cohort Study ◽  
Site Infection ◽  
Observational Cohort ◽  
Hip Fracture Mortality

scholarly journals PMS40 270-DAYMORTALITY AND ITS PREDICTORS IN WOMEN WITH CONTRALATERAL HIP FRACTURE AFTER FEMORAL NECK FRACTURE

2019 ◽  
Vol 22 ◽  
pp. S701
Author(s):  
K. Juhász ◽  
I. Boncz ◽  
B. Molics ◽  
B. Gratz ◽  
A. Sebestyén
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Neck Fracture

scholarly journals Az ellenoldali csípőtáji törésig eltelt időt befolyásoló prognosztikai tényezők vizsgálata

2018 ◽  
Vol 159 (38) ◽  
pp. 1543-1547
Author(s):  
Krisztina Juhász ◽  
Imre Boncz ◽  
Péter Kanizsai ◽  
Andor Sebestyén
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Hip Fractures ◽  
Age Groups ◽  
Significant Difference ◽  
Neck Fracture ◽  
The Impact

Abstract: Introduction: Although several national studies reported on the risk factors for contralateral hip fracture, there are no data about the prognostic factors of the time until contralateral hip fractures. Aim: The aim of the study was to analyse the impact of different prognostic factors on the time until the development of contralateral fracture and to determine the incidence of contralateral hip fractures after femoral neck fractures. Method: Patients aged 60 years and over with contralateral hip fracture between 01 Jan 2000 and 31 Dec 2008 were identified among those who suffered their femoral neck fracture in Hungary in 2000. Risk factors as age, sex, comorbidities, type of fracture and surgery, place of living and hospitals providing treatment for primary fracture were analysed by one way ANOVA focusing on the time until the development of contralateral hip fracture. Results: 312 patients met the inclusion criteria. The incidence of contralateral hip fracture after femoral neck fracture ranged between 1.5% and 2.1%, the cumulative incidence was 8.24%. The mean time until the development of contralateral hip fracture was 1159.8 days. The incidence of contralateral hip fracture showed no significant deviation. Significantly shorter time (p = 0.010) was detected until the contralateral hip fracture in older patients with femoral neck fracture. Conclusions: The yearly incidence of contralateral hip fracture showed no significant difference by patients with femoral neck fracture over 60 years. The shorter time until the contralateral hip fracture by the older age groups highlights the need of elaboration of prevention strategies. Orv Hetil. 2018; 159(38): 1543–1547.

Should we employ preoperative templating in hip hemiarthroplasty after femoral neck fracture? A nested case-control study

2020 ◽  
pp. 112070002096477
Author(s):  
Oriol Pujol ◽  
María G Carrasco ◽  
Matías Vicente ◽  
Iñaki Mimendia ◽  
Yaiza García ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Case Control Study ◽  
Neurological Impairment ◽  
Case Control ◽  
Hip Hemiarthroplasty ◽  
Radiological Parameters ◽  
Neck Fracture ◽  
Nested Case Control ◽  
Control Study

Introduction: Dislocation following hip hemiarthroplasty is a serious complication. It remains unclear if acetabular morphology is associated with a higher risk of dislocation. The aim of our study was to investigate whether there are differences in hip morphology radiological parameters between patients who have suffered a dislocation episode, and those who have not suffered a dislocation. Material and methods: Between January 2015 and December 2018, a nested case-control study was performed. From 707 patients who underwent hip hemiarthroplasty because of femoral neck fracture, 50 patients (50 hips) suffered an episode of dislocation. They were randomly matched with 94 patients (100 hips) without dislocation (ratio 1:2). Clinical data regarding demographics, medical comorbidities and surgical and radiological parameters were studied. Results: Statistically significantly smaller lateral centre-edge angle (LCEA) and femoral offset (FO) and greater Tönnis angle were found in the dislocation group. No differences in acetabular angle were seen. Neurological impairment prevalence was statistically significantly higher in patients who suffered a dislocation (60% vs. 44%, p = 0.011). Conclusions: The current study suggests that a smaller LCEA and FO, a greater TA, and neurological impairment could be related to a higher risk of hip hemiarthroplasty dislocation after femoral neck fracture in the elderly. We consider that preoperative templating could be helpful in identifying abnormal parameters and carefully planning surgery could lead to changes in treatment strategy, such as choosing a dual-mobility total hip arthroplasty.

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