Prevalence of venous thromboembolism in patients with acetabular or hip fractures and their association with hemoglobin concentration

Perioperative tranexamic acid use is a popular choice among many surgeons for reducing surgical blood loss and its sequelae. While there is evidence in the literature that tranexamic acid use is effective in reducing blood loss in surgery for patients with hip fractures, there is less information on whether it leads to thromboembolic complications. We undertook a retrospective study in patients with hip fractures at two local hospitals to investigate if there was an increased risk of venous thromboembolism in patients who received tranexamic acid, and whether it reduced perioperative blood loss and the need for transfusion. We found that tranexamic acid used in patients undergoing hip fracture surgery reduced the drop in postoperative haemoglobin and the need for postoperative blood transfusion but was not associated with an increased risk of venous thromboembolism.

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Patients with Hip Fractures Treated with Arthroplasty Demonstrate Prolongued Hypercoagulability and Increased Venous Thromboembolism Risk

OrthoMedia ◽

10.1302/3114-220867 ◽

2022 ◽

Keyword(s):

Venous Thromboembolism ◽

Hip Fractures

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Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations

Medicina ◽

10.3390/medicina56060311 ◽

2020 ◽

Vol 56 (6) ◽

pp. 311

Author(s):

Pichitchai Atthakomol ◽

Worapaka Manosroi ◽

Phichayut Phinyo ◽

Tanyong Pipanmekaporn ◽

Tanawat Vaseenon ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Prognostic Factors ◽

Hip Fracture ◽

Hip Fractures ◽

Hemoglobin Concentration ◽

Laboratory Evaluation ◽

Chronic Obstructive ◽

Chronic Obstructive Pulmonary Disorder ◽

Factors Associated ◽

Pulmonary Disorder

Background and Objectives: Although the types of comorbidities and laboratory evaluations are major factors associated with mortality after hip fractures, there have been no studies of the association of these factors and mortality in Thai hip-fracture patients. This study aimed to identify prognostic factors associated with mortality after a hip fracture in the Thai population, including types of comorbidities, treatment-related factors, and laboratory evaluations. Materials and Methods: This five-year retrospective study was conducted in a tertiary care hospital in Thailand. A total of 775 Thai patients who had been admitted with a hip fracture resulting from a simple fall were identified using the International Classification of Disease 10 codes, and a review of their medical charts was conducted. Associations between general factors, comorbidities, laboratory evaluations, treatment factors including type of treatment, and time to death were analyzed using the Cox proportional hazard regression and the hazard ratio (HR). Results: The overall mortality rate of hip fracture patients was 13.94%. Independent prognostic factors found to be significantly associated with mortality were nonoperative treatment (HR = 3.29, p < 0.001), admission glomerular filtration rate (GFR) < 30 mL/min/1.73 m2 (HR = 3.40, p < 0.001), admission hemoglobin concentration <10 g/dL. (HR = 2.31, p < 0.001), chronic obstructive pulmonary disorder (HR = 2.63, p < 0.001), dementia or Alzheimer’s disease (HR = 4.06, p < 0.001), and active malignancy (HR = 6.80, p < 0.001). Conclusion: The types of comorbidities and laboratory evaluation findings associated with mortality in Thai patients with hip fractures include chronic obstructive pulmonary disorder, dementia or Alzheimer’s disease, active malignancy, admission GFR < 30 mL/min/1.73 m2, and admission hemoglobin concentration <10 g/dL. The risks of mortality for Thai hip-fracture patients with these comorbidities or laboratory evaluation findings were 2.5, 4, 7, 3.5, and 2.5 times higher, respectively, than patients without those factors.

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Graduated compression stockings in hip fractures

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221592492 ◽

2012 ◽

Vol 94 (7) ◽

pp. 463-467 ◽

Cited By ~ 3

Author(s):

A Alsawadi ◽

M Loeffler

Keyword(s):

Venous Thromboembolism ◽

Hip Fracture ◽

Hip Fractures ◽

Literature Search ◽

Significant Risk ◽

Sufficient Evidence ◽

Cochrane Library ◽

Reference List ◽

Compression Stockings ◽

Graduated Compression Stockings

INTRODUCTION Hip fractures are the most common cause of acute admissions to orthopaedics and in the UK approximately 70,000–75,000 hip fractures occur annually. Hip fractures carry a significant risk of developing a venous thromboembolism. The National Institute for Health and Clinical Excellence (NICE) estimated that the risk of developing a venous thromboembolism in patients with hip fractures who do not receive thromboprophylaxis is 43%. In their recent guidelines, NICE recommended that combined mechanical and pharmacological thromboprophylaxis should be offered to patients undergoing hip fracture surgery and mechanical prophylaxis should be commenced at admission. The aim of this review was to search for available evidence that could support using graduated compression stockings combined with low molecular weight heparin (LMWH) in hip fracture patients. METHODS NICE guidelines and the reference list of the guidance were reviewed and a thorough literature search was performed on main electronic databases (MEDLINE®, Embase™ and the Cochrane Library). RESULTS A literature search was unable to find sufficient evidence to support the use of graduated compression stockings combined with LMWH in hip fracture settings. The guidelines are critically reviewed and the available evidence discussed. CONCLUSIONS The evidence supporting these recommendations is very limited and there is considerable concern regarding the safety and efficacy of the mechanical devices used in thromboprophylaxis. Further studies are needed urgently before specific guidelines can be agreed confidently for patients with hip fractures.

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