The Effects of Clopidogrel (Plavix) and Other Oral Anticoagulants on Early Hip Fracture Surgery

Collinge, Cory; Kelly, Kevin C.; Little, Bert; Weaver, Tara; Schuster, Richard D.

doi:10.1097/bot.0b013e318240d70f

Cited by 79 publications

(70 citation statements)

References 19 publications

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“…Sensitivity analysis did not affect overall estimates. When focusing on 30-day mortality only, five studies [30,51,52,54,56] were included in the analysis. Overall, they found no difference in mortality with an odds ratio of 1.10 (95% CI: 0.48-2.54) (Fig.…”

Section: Studymentioning

confidence: 99%

“…Thirty-one studies deemed to be relevant to the research question underwent full text review. Studies were excluded for the following reasons: Japanese language (1) [35]; paper was unavailable for review (1) [33]; clopidogrel group had a mean time to surgery of >7 days and was therefore felt to be non-comparable (2) [38,39]; letters (3) [36,40,41]; no comparison group (2) [42,43]; no relevant data (1) [34]; abstract only (1) [44]; surveys (3) [22,23,24]; no clopidogrel group (1) [45]; included patients on other antiplatelets (1) [32,46] and early surgery >48 h (2) [47,48] This left 12 studies, which were included in the review [30,31,[49][50][51][52][53][54][55][56][57][58].…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Eight studies [30,[51][52][53][54][56][57][58] were included in the metaanalysis of mortality at various time points in the clopidogrel versus no clopidogrel group (Table 1). Using the latest reported mortality time point from each of the studies, there was no associated increase in mortality (OR 0.89 (95% CI: 0.58-1.38)) ( Fig.…”

Section: Mortalitymentioning

confidence: 99%

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Is early hip fracture surgery safe for patients on clopidogrel? Systematic review, meta-analysis and meta-regression

Doleman

Moppett

2015

Injury

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Section: Studymentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Is early hip fracture surgery safe for patients on clopidogrel? Systematic review, meta-analysis and meta-regression

Doleman

Moppett

2015

Injury

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“…17 Two studies involving fracture surgeries both showed no differences in the rate of bleeding complications in patients on clopidogrel and in those who were not. 18,19 These results show that continuation of clopidogrel during the perioperative period may be safe in some orthopaedic surgeries.…”

Section: Patients On Clopidogrel Monotherapymentioning

confidence: 67%

Perioperative antithrombotic management in joint replacement surgeries

Chiu²,

Yiu³

et al. 2013

Hong Kong Med J

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531Objectives To determine optimal perioperative antithrombotic management for patients with cardiac diseases undergoing joint replacement surgeries.Data sources MEDLINE and PubMed database search up to January 2013.Study selection Those dealing with perioperative antithrombotic management of patients undergoing orthopaedic operations, especially joint replacement, and also those undergoing general surgery. Various combinations of the following key words were used in our search: "antiplatelet", "antithrombotic", "anticoagulant", "coronary stent", "perioperative", "venous thromboembolism", "cardiovascular", "surgery", "orthopaedic", "knee replacement", "hip replacement", "joint replacement", and "arthroplasty". Data extraction Literature review, original articles, and best practice guidelines.Data synthesis Patients should be stratified according to their risk of developing arterial thromboembolism in order to decide the most appropriate perioperative antiplatelet or anticoagulant regimen for them. After recent coronary stenting, including bare-metal stents implanted within 6 weeks and drug-eluting stents implanted within 6 months, surgery should be deferred. For venous thromboembolism prophylaxis in patients already on aspirin, the dosage should be adjusted as necessary or additional low-molecular-weight heparin administered. ConclusionThe perioperative management of patients with cardiac diseases in receipt of antithrombotic agents is based upon a delicate balance between the perceived risk of arterial thromboembolism and the perceived risk of perioperative bleeding. One must exercise good judgement in deciding the most appropriate perioperative antithrombotic regimen. Venous thromboembolism is also a common problem after joint replacement surgeries. For patients already on aspirin, optimal venous thromboembolism prophylaxis is still being debated.Perioperative antithrombotic management in joint replacement surgeries R E V I E W A R T I C L E

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“…Recent studies have shown that early surgery in patients on clopidogrel and warfarin is safe with no increase in observed complications. [14][15][16] Removal of this delay would improve our time to surgery. Addition of a standardized pain management program and fracture prevention program may further improve our results.…”

Section: Discussionmentioning

confidence: 99%

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Jain

Selhi

Mears

et al. 2015

Geriatr Orthop Surg Rehabil

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Geriatric hip fractures are a challenging clinical problem throughout the world. Hip fracture services have been shown to shorten time to surgery, decrease the cost of admissions, and improve the outcomes. We instituted a geriatric hip fracture program for comanagement of these injuries by orthopedic and internal medicine teams at our hospital in India. From January 2010 till December 2011, 119 patients with a femoral neck fracture were treated with cemented modular hemiarthroplasty under this program using a cost-effective Indian implant. The cohort included 63 males and 56 females with a mean age of 70.7 years (range 55-98 years). Hypertension (n ¼ 42) and diabetes mellitus (n ¼ 29) were the most common comorbidities. The follow-up period ranged from 12 to 37 months with an average of 24 months. The surgery was performed within 24 hours of admission in 60.5% (n ¼ 72) patients. The use of antiplatelet drugs was the most common reason for delay of surgery. The mean length of hospital stay was 10.4 days (range 3-24 days) with 77% (n ¼ 92) of patients discharged within 1 week of admission. On follow-up, good to excellent Harris hip scores were seen in 88% of patients with 76% of patients returning to the preinjury ambulatory status. The mortality rate was 6% at 6 months follow-up and 10.9% at 2 years. Our study shows that a hip fracture program can be instituted in India. The program helped us in achieving the goal of early surgery, mobilization, and discharge from hospital with decreased mortality.

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The Effects of Clopidogrel (Plavix) and Other Oral Anticoagulants on Early Hip Fracture Surgery

Cited by 79 publications

References 19 publications

Is early hip fracture surgery safe for patients on clopidogrel? Systematic review, meta-analysis and meta-regression

Is early hip fracture surgery safe for patients on clopidogrel? Systematic review, meta-analysis and meta-regression

Perioperative antithrombotic management in joint replacement surgeries

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

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