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Vol. 59. Issue 2.
Pages 104-111 (March - April 2015)
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Vol. 59. Issue 2.
Pages 104-111 (March - April 2015)
Original Article
DOI: 10.1016/j.recote.2015.01.005
Anti-platelet drugs in patients with femoral neck fractures undergoing cemented hip hemiarthroplasty surgery. A study of complications and mortality
Antiagregación en pacientes con fractura subcapital desplazada de fémur tratados con prótesis parcial cementada. Estudio de complicaciones y mortalidad
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M. Agudo Quiles, J. Sanz-Reig
Corresponding author
javisanz@coma.es

Corresponding author.
, R. Alcalá-Santaella Oria de Rueca
Servicio de Cirugía Ortopédica, Hospital Universitario San Joan d’Alacant, Sant Joan d’Alacant, Alicante, Spain
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Figures (1)
Tables (3)
Table 1. Preoperative data, both groups.
Table 2. Cumulative mortality, both groups.
Table 3. Data from patients treated with anti-platelet drugs.
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Abstract
Objective

To assess complications and factors predicting one-year mortality in patients on anti-platelet agents presenting with femoral neck fractures undergoing hip hemiarthroplasty surgery.

Material and methods

A review was made on 50 patients on preoperative anti-platelet agents and 83 patients without preoperative anti-platelet agents. Patients in both groups were treated with cemented hip hemiarthroplasty. A statistical comparison was performed using epidemiological data, comorbidities, mental state, complications and mortality. There was no lost to follow-up.

Results

The one-year mortality was 20.3%. In patients without preoperative anti-platelet agents it was 14.4% and in patients with preoperative anti-platelet agents was 30%. Age, ASA grade, number of comorbidities and anti-platelet agent therapy were predictors of one-year mortality.

The one-year mortality of patients on clopidogrel was 46.1%, versus 24.3% in patients on acetylsalicylic acid.

Conclusion

Patients with preoperative anti-platelet therapy were older and had greater number of comorbidities, ASA grade, delayed surgery, and a longer length of stay than patients without anti-platelet therapy. The one-year mortality was higher in patients with preoperative anti-platelet therapy.

Keywords:
Hip fracture
Antiplatelet agents
Hip prostheses
Complications
Mortality
Resumen
Objetivo

Evaluar las complicaciones y la mortalidad en pacientes antiagregados con fractura cervical desplazada de cadera tratada con prótesis parcial.

Material y método

Estudio de 133 pacientes en el período 2008 a 2010 que se distribuyeron en 2 grupos, con tratamiento antiagregante en el momento del ingreso (50 pacientes) y sin tratamiento antiagregante (83 pacientes). Todos tratados mediante sustitución parcial de cadera con implante de prótesis parcial modular cementada. Se valoraron los datos epidemiológicos, comorbilidades, estado mental, complicaciones y mortalidad. No hubo pérdidas de seguimiento.

Resultados

La mortalidad anual de la serie completa fue del 20,3%; en pacientes no antiagregados, del 14,4%, y en pacientes antiagregados, del 30%. Los predictores de mortalidad a los 12meses fueron la edad, el grado ASA, el número de comorbilidades asociadas y la antiagregación.

Los pacientes antiagregados con clopidogrel tuvieron una mortalidad del 46,1%, frente al 24,3% de los pacientes antiagregados con ácido acetilsalicílico.

Conclusiones

Los pacientes antiagregados tenían mayor edad, número de comorbilidades, grado ASA, demora quirúrgica y estancia hospitalaria que los no antiagregados. A los 12meses de la cirugía la mortalidad acumulada ha sido mayor en pacientes antiagregados que en los no antiagregados.

Palabras clave:
Fractura de cadera
Inhibidores de la agregación plaquetaria
Prótesis de cadera
Complicaciones
Mortalidad

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