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[HIP FRACTURE SURGERY DELAY IN PATIENTS TREATED WITH ORAL ANTICOAGULANTS: RESULTS FROM SHEBA MEDICAL CENTER]
Amit Levi1, Nati Bor2, Anna Seltser3
1Arrow Program for Medical Research Education, Sheba Medical Center Tel-Hashomer, Israel, Adelson School of Medicine, Ariel University.
Background:
Hip fractures (HF) are a major cause of morbidity and mortality in the elderly population. Many factors are associated with HF post-operative prognosis, among them the admission to operation time (AOT) is a major factor. Delayed surgery (> 48 hours) is associated with increased morbidity and mortality. The use of anti-coagulants (OAC) often leads to surgery delay to prevent possible surgical bleeding.
Objectives:
To test the association between the use of OAC and AOT.
Methods:
The study was a retrospective cohort of consecutive patients above 65 years of age admitted and operated for hip fracture at the Sheba Medical Center between the years 2014-2018. We compared AOT between OAC treated and non-treated patients. We conducted multi-variable analysis to examine the effect of OAC on AOT.
Results:
Overall, 1013 case patients were studied, among them 151 were treated with OAC (research group) and 865 patients without any anti-coagulation treatment (control group). Surgery delay over 48 hours was observed in 24.6% OAC treated patients compared to 12% in the non-treatment group (p=0.0001). Median AOT was 32 hours compared to 24.6 hours in treated vs non-treated patients, respectively, p=0.0001. Apixaban is the only drug found not to prolong AOT. In multivariate analysis OAC therapy was the only significant cause for surgical delay.
Conclusions:
Patients with HF treated with anti-coagulants are experiencing delayed surgery compared to non-treated patients.
