在服用直接口服抗凝剂的患者中,早期的部骨折手术改善了结果
Benjamin K Devlieger1,2, Pol M Rommens2, Andreas Baranowski2,3
1Department of Orthopaedics and Traumatology Westpfalz-Klinikum, 67655 Kaiserslautern, Germany.
Journal of clinical medicine
|August 29, 2024
概括
接受直接口服抗凝剂的部骨折的老年患者可以在24小时内从早期手术中受益. 早期干预可以减少住院和并发症,改善这个不断增长的患者群体的治疗结果.
科学领域:
- 老年人手术是一门老年人手术.
- 整形外科 整形外科 整形外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 骨折在老年人中很常见,越来越多的患者服用抗凝药.
- 直接口服抗凝剂 (DOAC) 存在出血风险,并复杂化术后管理.
- 目前的选择性手术指南涉及停止DOACs,但最佳的紧急部手术时间尚不清楚.
研究的目的:
- 为了评估早期手术治疗关节骨折的好处,在老年患者服用直接口服抗凝剂.
- 为了确定早期手术是否会影响术后的结果,无论从最后一次DOAC剂量以来的时间有多长.
主要方法:
- 对340名关节骨折患者的回顾性分析,包括59名直接口服抗凝剂患者.
- 主要结局:手术的时间,输血率,血红蛋白变化,停留时间和并发症率.
主要成果:
- 在24小时内手术的DOAC患者住院时间较短 (p=0.0167).
- 早些时候的手术与术后输血和医疗并发症率较低有关.
- 在DOAC组中观察到血液瘤的更高修订率,独立于手术时间.
结论:
- 直接抗凝血治疗的骨骨折患者应考虑早期手术干预.
- 早期手术可以改善恢复,并减少这种患者群体的并发症.
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