Complicaciones asociadas al retraso en la cirugía de fractura de cadera por antiagregantes plaquetarios

Abstract

Background and objectives

Hip fractures typically affect elderly individuals with multiple comorbidities. Early surgical intervention within the first 48 hours has been shown to improve outcomes. However, when on antiplatelet therapy, surgery is often delayed preventing bleeding complications. This study aims to compare the incidence of perioperative complications, the need for blood transfusions, and the length of hospital stay between two groups of patients: those with delayed surgery more than 72 hours due to antiplatelet use and those who had surgery within the first 48 hours.

Methods

A retrospective cohort study was conducted on 110 patients who underwent hip fracture surgery between December 2012 and April 2018. Patients who had a delay of more than 72 hours in the surgery were selected. A 1:1 randomized sampling was made to obtain a control group with surgery within the first 48 hours.

Results

The baseline clinical characteristics were similar between the two groups, except for a higher rate of ischemic heart disease, cerebrovascular accidents and use of antiplatelet medication in the delayed surgery group. The early surgery group had a higher rate of acute renal failure (14.6% vs. 1.8%). The rest of the postoperative complications were higher in the delayed group (5.5% vs. 20%). The hospital stay was longer in the delayed group (15.2 vs. 8.93 days), although this difference accounted for the preoperative stay.

Conclusion

This study found that delayed surgery was linked to a higher incidence of medical complications and a longer hospital stay due to the wait time for surgery.