With the aging population, an increasing number of elderly patients are being treated for hip fractures. Current estimates place this number above 300,000 hip fracture hospital admissions annually, which is expected to increase in the next decade. As this hip fracture population ages, an increasing number of patients have comorbidities requiring chronic anticoagulation medications. Treating physicians are often perplexed about how to manage the fracture in light of anticoagulation. The paper by Lin et al. adds to the already existing body of literature that demonstrates patients who present on antiplatelet medications can safely undergo hip fracture surgery within 48 hours with no increase in short term or long-term mortality. These authors focused on the use of Dipyridamole, whereas others have focus on other antiplatelet meds such as Clopidogrel. Our group has looked at these medications along with other anticoagulants and found that after controlling for age, co-morbidities, and anesthesia type, patients who presented on anticoagulation had similar lengths of stays, surgical outcomes, total complication rates, and admission costs to those patients not on anticoagulation.
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Kenneth A. Egol, MD
NYU Langone Health
Disclosures: Egol reports no relevant financial disclosures.