Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio
In current clinical practice, orthopedic surgeons often delay the surgery intervention on geriatric hip fracture patients to optimize the international normalized ratio (INR), in order to decrease the risk of postoperative hematological complications. However, some evidence suggests that full revers...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-07-01
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| Series: | Geriatrics |
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| Online Access: | https://www.mdpi.com/2308-3417/5/3/43 |
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| author | Michael S. Kain David Saper Kyle Lybrand Kasey-Jean Bramlett Paul Tornetta III Peter Althausen John S. Garfi Donald P. Willier III Ruijia Niu Andrew J. Marcantonio |
| author_facet | Michael S. Kain David Saper Kyle Lybrand Kasey-Jean Bramlett Paul Tornetta III Peter Althausen John S. Garfi Donald P. Willier III Ruijia Niu Andrew J. Marcantonio |
| author_sort | Michael S. Kain |
| collection | DOAJ |
| description | In current clinical practice, orthopedic surgeons often delay the surgery intervention on geriatric hip fracture patients to optimize the international normalized ratio (INR), in order to decrease the risk of postoperative hematological complications. However, some evidence suggests that full reversal protocols may not be necessary, especially for patients with prior thromboembolic history. Our study aims to compare the surgical outcomes of patients with normal versus elevated INR values. We conducted a retrospective chart review on 217 patients who underwent surgeries on hip fractures at two academic trauma centers. We found that in our group (n = 124) of patients with an INR value of 1.5–3.0, there was only one reoperation for a hematoma, but there was a trend for more blood transfusions. There was no statistically significant difference in the odds of reoperation or overall complications. Nevertheless, there were significantly more events of postoperative anemia in this high INR patient group. |
| first_indexed | 2024-03-10T18:28:16Z |
| format | Article |
| id | doaj.art-021f76fb41c742f296ab02d2e523603e |
| institution | Directory Open Access Journal |
| issn | 2308-3417 |
| language | English |
| last_indexed | 2024-03-10T18:28:16Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Geriatrics |
| spelling | doaj.art-021f76fb41c742f296ab02d2e523603e2023-11-20T06:48:07ZengMDPI AGGeriatrics2308-34172020-07-01534310.3390/geriatrics5030043Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized RatioMichael S. Kain0David Saper1Kyle Lybrand2Kasey-Jean Bramlett3Paul Tornetta III4Peter Althausen5John S. Garfi6Donald P. Willier III7Ruijia Niu8Andrew J. Marcantonio9Department of Orthopaedic Surgery, Boston Medical Center, 850 Harrison Avenue, Boston, MA 02118, USAOrthopaedic and Rehabilitation Centers, 5616 North Western Avenue, Chicago, IL 60659, USAOrtho Montana, 2900 12th Avenue North, Billings, MT 59101, USADepartment of Orthopaedic Surgery, Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805, USADepartment of Orthopaedic Surgery, Boston Medical Center, 850 Harrison Avenue, Boston, MA 02118, USAReno Orthopaedic Clinic, Reno, NV 89503, USADepartment of Orthopaedic Surgery, Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805, USADepartment of Orthopaedic Surgery, Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805, USADepartment of Orthopaedic Surgery, Boston Medical Center, 850 Harrison Avenue, Boston, MA 02118, USADepartment of Orthopaedic Surgery, Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805, USAIn current clinical practice, orthopedic surgeons often delay the surgery intervention on geriatric hip fracture patients to optimize the international normalized ratio (INR), in order to decrease the risk of postoperative hematological complications. However, some evidence suggests that full reversal protocols may not be necessary, especially for patients with prior thromboembolic history. Our study aims to compare the surgical outcomes of patients with normal versus elevated INR values. We conducted a retrospective chart review on 217 patients who underwent surgeries on hip fractures at two academic trauma centers. We found that in our group (n = 124) of patients with an INR value of 1.5–3.0, there was only one reoperation for a hematoma, but there was a trend for more blood transfusions. There was no statistically significant difference in the odds of reoperation or overall complications. Nevertheless, there were significantly more events of postoperative anemia in this high INR patient group.https://www.mdpi.com/2308-3417/5/3/43hip fractureINRanticoagulationpostoperative complications |
| spellingShingle | Michael S. Kain David Saper Kyle Lybrand Kasey-Jean Bramlett Paul Tornetta III Peter Althausen John S. Garfi Donald P. Willier III Ruijia Niu Andrew J. Marcantonio Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio Geriatrics hip fracture INR anticoagulation postoperative complications |
| title | Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio |
| title_full | Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio |
| title_fullStr | Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio |
| title_full_unstemmed | Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio |
| title_short | Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio |
| title_sort | postoperative complications of hip fractures patients on chronic coumadin a comparison based on operative international normalized ratio |
| topic | hip fracture INR anticoagulation postoperative complications |
| url | https://www.mdpi.com/2308-3417/5/3/43 |
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