Implications of anticoagulant and antiplatelet therapy in patients presenting with hip fractures: a current concepts review

Authors: Gulati, V., Newman, S., Porter, K., Franco, L., Wainwright, T., Ugoigwe, C. and Middleton, R.

Journal: HIP International

Publisher: Wichtig Publishing

ISSN: 1120-7000

DOI: 10.1177/1120700018759300

The increasing use of anticoagulant and antiplatelet therapy for the prevention of thromboembolic disease poses a significant challenge to orthopaedic surgeons treating elderly patients presenting with proximal femoral fractures. Early surgical intervention is known to be beneficial from a clinical perspective and has been encouraged in the UK through the introduction of best practice tariffs providing increased remuneration for prompt treatment. An understanding of the necessary delay to surgery or reversal options for each type of antiplatelet or anticoagulant agent is therefore important. A number of professional bodies have recently produced guidelines that help clinicians manage these patients during the peri-operative period.

We review the guidelines relating to antiplatelet and anticoagulant agents during the perioperative period with respect to hip fracture surgery.

Antiplatelet agents should not interfere with timing of surgery, but may affect the choice of anaesthetic performed. The action of warfarin should be reversed to expedite surgery. Newer direct oral anticoagulants are more problematic and surgical delay may be necessary, though reversal agents are becoming available.

This data was imported from PubMed:

Authors: Gulati, V., Newman, S., Porter, K.J., Franco, L.C.S., Wainwright, T., Ugoigwe, C. and Middleton, R.

Journal: Hip Int

Volume: 28

Issue: 3

Pages: 227-233

eISSN: 1724-6067

DOI: 10.1177/1120700018759300

The increasing use of anticoagulant and antiplatelet therapy for the prevention of thromboembolic disease poses a significant challenge to orthopaedic surgeons treating elderly patients presenting with proximal femoral fractures. Early surgical intervention is known to be beneficial from a clinical perspective and has been encouraged in the UK through the introduction of best practice tariffs providing increased remuneration for prompt treatment. An understanding of the necessary delay to surgery or reversal options for each type of antiplatelet or anticoagulant agent is therefore important. A number of professional bodies have recently produced guidelines that help clinicians manage these patients during the peri-operative period. We review the guidelines relating to antiplatelet and anticoagulant agents during the perioperative period with respect to hip fracture surgery. Antiplatelet agents should not interfere with timing of surgery, but may affect the choice of anaesthetic performed. The action of warfarin should be reversed to expedite surgery. Newer direct oral anticoagulants are more problematic and surgical delay may be necessary, though reversal agents are becoming available.

This data was imported from Scopus:

Authors: Gulati, V., Newman, S., Porter, K.J., Franco, L.C.S., Wainwright, T., Ugoigwe, C. and Middleton, R.

Journal: HIP International

Volume: 28

Issue: 3

Pages: 227-233

ISSN: 1120-7000

DOI: 10.1177/1120700018759300

© The Author(s) 2018. The increasing use of anticoagulant and antiplatelet therapy for the prevention of thromboembolic disease poses a significant challenge to orthopaedic surgeons treating elderly patients presenting with proximal femoral fractures. Early surgical intervention is known to be beneficial from a clinical perspective and has been encouraged in the UK through the introduction of best practice tariffs providing increased remuneration for prompt treatment. An understanding of the necessary delay to surgery or reversal options for each type of antiplatelet or anticoagulant agent is therefore important. A number of professional bodies have recently produced guidelines that help clinicians manage these patients during the peri-operative period. We review the guidelines relating to antiplatelet and anticoagulant agents during the perioperative period with respect to hip fracture surgery. Antiplatelet agents should not interfere with timing of surgery, but may affect the choice of anaesthetic performed. The action of warfarin should be reversed to expedite surgery. Newer direct oral anticoagulants are more problematic and surgical delay may be necessary, though reversal agents are becoming available.

This data was imported from Web of Science (Lite):

Authors: Gulati, V., Newman, S., Porter, K.J., Franco, L.C.S., Wainwright, T., Ugoigwe, C. and Middleton, R.

Journal: HIP INTERNATIONAL

Volume: 28

Issue: 3

Pages: 227-233

eISSN: 1724-6067

ISSN: 1120-7000

DOI: 10.1177/1120700018759300

The data on this page was last updated at 04:53 on April 26, 2019.