Preoperative antithrombotic therapy and risk of blood transfusion and mortality following hip fracture surgery: a Danish nationwide cohort study

医学 髋部骨折 抗血栓 输血 维生素K拮抗剂 危险系数 外科 共病 队列研究 相对风险 氨甲环酸 内科学 置信区间 骨质疏松症 华法林 心房颤动 失血
作者
Cecilie Daugaard,Alma B Pedersen,Nickolaj Risbo Kristensen,Søren Paaske Johnsen
出处
期刊:Osteoporosis International [Springer Nature]
卷期号:30 (3): 583-591 被引量:42
标识
DOI:10.1007/s00198-018-4786-0
摘要

Hip fracture surgery is associated with high risk of bleeding and mortality. The patients often have cardiovascular comorbidity, which requires antithrombotic treatment. This study found that preoperative use of oral anticoagulants was not associated with transfusion or mortality following hip fracture surgery, whereas increased risk may exist for antiplatelet drugs.Hip fracture surgery is associated with high bleeding risk and mortality; however, data on operative outcomes of hip fracture patients admitted while on antithrombotic therapy is sparse. We examined if preoperative antithrombotic treatment was associated with increased use of blood transfusion and 30-day mortality following hip fracture surgery.Using data from the Danish Multidisciplinary Hip Fracture Registry, we identified 74,791 hip fracture surgery patients aged ≥ 65 years during 2005-2016. Exposure was treatment with non-vitamin K antagonist oral anticoagulant (NOAC), vitamin K antagonists (VKA), or antiplatelet drugs at admission for hip fracture. Outcome was blood transfusion within 7 days postsurgery and death within 30 days.A 45.3% of patients received blood transfusion and 10.6% died. Current NOAC use was associated with slightly increased risk of transfusion (adjusted relative risk (aRR) 1.07, 95% confidence interval (CI) 1.01-1.14), but similar mortality risk (adjusted hazard ratio (aHR) 0.88, 95% CI 0.75-1.03) compared with non-users. The pattern remained when restricting to patients with short surgical delay (< 24 h). VKA users did not have increased risk of transfusion or mortality. The risks of transfusion (aRR 1.15 95% CI 1.12-1.18) and 30-day mortality (aHR 1.18 95% CI 1.14-1.23) were increased among antiplatelet users compared with non-users.In an observational setting, neither preoperative NOAC nor VKA treatments were associated with increased risk of 30-day postoperative mortality among hip fracture patients. NOAC was associated with slightly increased risk of transfusion. Preoperative use of antiplatelet drugs was associated with increased risk of transfusion and mortality.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
1秒前
1秒前
Bubble完成签到,获得积分10
2秒前
1518完成签到,获得积分10
2秒前
田様应助咕咕咕采纳,获得10
3秒前
xiaolu发布了新的文献求助10
3秒前
美式加热完成签到,获得积分10
3秒前
贺贺发布了新的文献求助10
4秒前
lyric完成签到,获得积分10
4秒前
乐观银耳汤完成签到,获得积分10
5秒前
RR猫发布了新的文献求助10
5秒前
Bubble发布了新的文献求助10
5秒前
5秒前
fenghy完成签到,获得积分10
5秒前
斯文败类应助科研民工采纳,获得10
5秒前
5秒前
ChiariRay完成签到,获得积分10
5秒前
Epiphany发布了新的文献求助10
7秒前
zhihe发布了新的文献求助10
7秒前
7秒前
李健应助欣慰慕灵采纳,获得10
7秒前
8秒前
8秒前
sun完成签到,获得积分10
8秒前
欢喜的荔枝完成签到,获得积分20
8秒前
科研通AI5应助自然紫山采纳,获得10
8秒前
酷波er应助热情语柔采纳,获得10
8秒前
9秒前
xxy完成签到,获得积分10
9秒前
浅学者发布了新的文献求助10
11秒前
yiyi发布了新的文献求助10
11秒前
12秒前
泡芙发布了新的文献求助10
12秒前
13秒前
yuqianyuan发布了新的文献求助30
13秒前
13秒前
络桵发布了新的文献求助10
14秒前
14秒前
宋老三完成签到,获得积分10
14秒前
高分求助中
Continuum thermodynamics and material modelling 3000
Production Logging: Theoretical and Interpretive Elements 2500
Healthcare Finance: Modern Financial Analysis for Accelerating Biomedical Innovation 2000
Applications of Emerging Nanomaterials and Nanotechnology 1111
Les Mantodea de Guyane Insecta, Polyneoptera 1000
Theory of Block Polymer Self-Assembly 750
지식생태학: 생태학, 죽은 지식을 깨우다 700
热门求助领域 (近24小时)
化学 医学 材料科学 生物 工程类 有机化学 生物化学 纳米技术 内科学 物理 化学工程 计算机科学 复合材料 基因 遗传学 物理化学 催化作用 细胞生物学 免疫学 电极
热门帖子
关注 科研通微信公众号,转发送积分 3473880
求助须知:如何正确求助?哪些是违规求助? 3066292
关于积分的说明 9098435
捐赠科研通 2757536
什么是DOI,文献DOI怎么找? 1512974
邀请新用户注册赠送积分活动 699232
科研通“疑难数据库(出版商)”最低求助积分说明 698909