Preoperative anticoagulation and its impact on surgical timing and postoperative outcomes in hip fracture surgery: a retrospective study at an Orthogeriatrics Clinical Care Center in Colombia.

Abstract

Purpose: The management of elderly patients undergoing hip fracture surgery often involves those on anticoagulation therapy, posing challenges in surgical timing and outcomes. This study evaluates the prevalence of anticoagulation therapy, its impact on surgical timing, and postoperative outcomes within an Orthogeriatric Clinical Care Center (OCCC).

Methods: A retrospective review of 638 patients aged 65 and above treated for hip fractures from May 2014 to December 2023 at the OCCC was conducted. Data on anticoagulant use, surgical timing, and outcomes were analyzed using multivariate logistic regression to adjust for confounders, such as age, preoperative hemoglobin levels, and comorbidities.

Results: Anticoagulation therapy was present in 14.7% of patients, primarily with direct oral anticoagulants (12.2%). There was no significant delay in surgical timing for anticoagulated patients (mean time to surgery: 31.5 ± 23.3 h) compared to non-anticoagulated patients (28.7 ± 15.7 h, p = 0.272). Additionally, no significant differences were observed in transfusion requirements, ICU admissions, or mortality rates at 30 days and 1 year postoperatively between the two groups.

Conclusion: Timely surgery for hip fractures is achievable in elderly patients on anticoagulation therapy and does not negatively impact critical postoperative outcomes when managed within a structured OCCC protocol. These findings support the use of standardized perioperative anticoagulation management protocols to ensure timely surgery and optimize patient recovery. Further research is recommended to validate these findings in broader clinical settings.