Chechik O. Injury. 2011;42:1277-1282.
Hip fracture surgery need not be delayed because
patients are receiving antiplatelet drugs, researchers for a study of blood
loss and surgery-related complications found.
“Notably, delay of surgical intervention for hip
fracture repair for more than 48 hours has been reported to increase
perioperative complications and mortality,” the researchers wrote.
Researchers measured intraoperative and perioperative
blood loss, the volume of transfused blood and surgery-related complications in
two groups. One group of 44 patients received continuous clopidogrel treatment
while a control group of 44 patients did not receive clopidogrel (either
aspirin alone or not on any antiplatelet therapy).
The team reported mean perioperative blood loss of 899
± 496 mL for patients not on clopidogrel, 1,091 ± 654 mL for
those on clopidogrel and 1,312 ± 686 mL for those on combined
clopidogrel and aspirin. No cases of mortality were reported in the early
postoperative period. A shorter time to operation and prolonged surgical time
were associated with increased blood loss.
Although the researchers said the antiplatelet effect
ceases in nearly 10 days, “their (antiplatelet drugs) effect on
surgery-related blood loss and perioperative complications is unclear and
management of trauma patients treated by antiplatelets is controversial.”