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· DOS Abstracts
Hip Fracture Surgery and New Oral Anticoagulants
– An Increasing Problem?
Charlotte Packroff Stenqvist, Naja Bjørslev, Susanne van der Mark
Department of Orthopaedic Surgery , Bispebjerg University Hospital of
Copenhagen; Department of Orthopaedic Surgery , Bispebjerg University
Hospital of Copenhagen; Department of Orthopaedic Surgery , Bispebjerg
University Hospital of Copenhagen
Background:
Early surgery has been shown to be associated with lower mor-
tality and complication rates in patients experiencing a hip fracture. New Oral
AntiCoagulants (NOACs) have been approved since 2008; 20% of Danish pa-
tients receiving antithrombotics medicate with NOACs. NOACs are prescribed
to prevent thrombo- embolic events in patients with atrial fibrillation and as
prophylaxis after surgery. The rising consumption of NOACs is an increasing
problem for trauma surgeons due to a half-life of 7-17 hours with normal renal
function and increasing risk of uncontrolled bleeding. NOAC treatment can lead
to postponement of acute surgery.
Purpose / Aim of Study:
The aim of this study is to analyse the percentage
of hip fracture patients admitted in 2015, who received NOACs or other an-
tithrombotics, and if surgery was delayed due to NOACs.
Materials and Methods:
Chart review from 1 January 2015-31 December
2015, using ICD-10 codes DS72.0-DS72.2. We excluded re- operations,
periprosthetic fractures and contralateral hip fracture within the same year.
Findings / Results:
We found 451 patients admitted with a hip fracture, 435
were included. 185 (42.5%) patients received antithrombotic treatment. 44.7%
were treated with acetylsalicylic acid, 24.4% with Clopidogrel, 12.7% received
Vitamin K-antagonist and 4.1% Adenosine re-uptake inhibitor. 27 patients
(13.7%) were treated with NOACs. Nine received Dabigatran, 11 Rivaroxaban
and seven Apixaban. In 24 of 27 patients receiving NOACs, surgery was delayed
1-3 days because of NOAC treatment. During 2015, 6.2 % of all hip fracture
patients in our department received NOACs. Surgery was postponed in 89 % of
these patients.
Conclusions:
We see an increasing consumption of NOACs in Denmark, our
data reveals the necessity that orthopedic surgeons are professionally updated
on perioperative complications associated with NOAC treatment.
No conflicts of interest reported
171.