62 / 225
62
· DOS Abstracts
Perioperative antithrombotic therapy and risk of blood
transfusion and mortality following hip fracture sur-
gery: A Danish nationwide cohort study
Cecilie Daugaard, Nickolaj Risbo Kristensen, Alma Becic Pedersen, Søren Paaske
Johnsen
Department of Clinical Epidemiology, Aarhus University Hospital
Background:
Hip fracture is associated with high bleeding risk and mortality.
The patients are often elderly and comorbid requiring various drugs, however,
little is known about the effect of ongoing antithrombotic therapy on outcome
among patients undergoing hip fracture surgery.
Purpose / Aim of Study:
To determine if anticoagulants and antiplatelets
are associated with increased use of blood transfusion and 30 days mortality
among hip fracture patients.
Materials and Methods:
A nationwide cohort study was performed. We in-
cluded 56,420 patients aged ≥ 65 years who underwent hip fracture surgery
during 2005-2013, using the Danish Hip Fracture Database. Patient character-
istics were depicted according to antithrombotic treatment. We determined and
compared the cumulative risk of blood transfusion within 7 days of surgery and
death within 30 days.
Findings / Results:
Following hip fracture surgery, 47.7% received blood
transfusion and 10.7% died within 30 days. Current vitamin K antagonists
(VKA) treatment at the time of hip fracture did not increase the risk of transfu-
sion; adj. relative risk (RR) was 0.97 (95% CI 0.93-1.02) nor the risk of 30 days
mortality; adj. hazard ratio (HR) was 0.92 (95% CI 0.79-1.07). In contrast, both
the risk of transfusion and 30 days mortality was increased among hip fracture
patients on antiplatelet therapy. The adj. RR for transfusion was 1.14 (95% CI
1.11-1.18) and adj. HR for 30 days mortality was 1.19 (95% CI 1.13-1.26).
Updated data including data on non-vitamin K antagonist oral anticoagulants will
be available at the meeting.
Conclusions:
Hip fracture patients preoperatively treated with VKA had no in-
creased risk of transfusion or 30 days mortality. In contrast, use of antiplatelet
drugs was associated with significantly increased risk of transfusion and higher
30 days all-cause mortality.
No conflicts of interest reported
14.