Clopidogrel has no effect on mortality from hip fracture

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Pharmacology

Background:

• Proximal femoral fractures affect over 76,000 UK patients annually.
• Clopidogrel is a widely used antiplatelet medication.
• Optimal surgical timing for hip fracture patients on clopidogrel is debated.

Purpose of the Study:

• To investigate the safety and outcomes of timely surgical intervention for hip fracture patients concurrently taking clopidogrel.

Main Methods:

• A consecutive series of 1225 hip fracture patients over six years.
• Analysis of 30 patients taking clopidogrel at the time of fracture.
• Comparison of outcomes including ASA grade, blood loss, transfusion, wound complications, and one-year mortality.

Main Results:

• No significant differences were observed in ASA grade, intra-operative blood loss, or transfusion requirements.
• Post-operative wound complications and one-year mortality showed no significant difference between groups.
• Patients on clopidogrel experienced similar outcomes to those not on the medication.

Conclusions:

• Timely surgical intervention is safe for hip fracture patients taking clopidogrel.
• Delaying surgery for these patients is not supported by the study findings.
• Prompt surgical management should be considered regardless of clopidogrel use.