Key result
Long-term anticoagulation linked to ~65% greater risk of non-infectious wound complications after hip hemiarthroplasty.
Why the study?
Many older adults who sustain femoral neck fractures receive long-term anticoagulation therapy, which may negatively affect surgical wound complications after hip hemiarthroplasty.
Does long-term anticoagulation therapy increase 90-day surgical wound complications in patients ≥ 60 years old undergoing hip hemiarthroplasty for femoral neck fracture?
Cohort (n=14,436)
Yes
Does long-term anticoagulation therapy increase 90-day surgical wound complications in patients ≥ 60 years old undergoing hip hemiarthroplasty for femoral neck fracture?
Odds Ratio: 1.65 (95% CI 1.27–2.15)
Absolute Event Rate: 2.15% vs 1.29%
p-value: p=<0.001
Long-term anticoagulation therapy is associated with an increased risk of 90-day infectious and non-infectious surgical wound complications in older adults undergoing hip hemiarthroplasty for femoral neck fracture.
Long-term anticoagulation may raise wound complication risk after HA; leaves open whether to alter protocols pending prospective data.
PURPOSE: Femoral neck fractures in older adults are commonly treated with hip hemiarthroplasty (HA). Many older adults who sustain femoral neck fractures are also receiving long-term anticoagulation therapy, which may negatively affect patient outcomes after HA. We sought to investigate whether long-term anticoagulation therapy is associated with increased risks of surgical wound complications among older adults treated with HA for femoral neck fracture. METHODS: Patients ≥ 60 years old who underwent HA within two days of admission for femoral neck fracture between October 1, 2015-December 31, 2021 were identified using codes in the Premier Healthcare Database. Long-term anticoagulation therapy was defined as an active prescription of anticoagulant medication at time of admission. A propensity score for the probability of long-term anticoagulant therapy was used to match patients. The adjusted odds of 90-day infectious surgical wound complications (deep and superficial) and non-infectious surgical wound complications (wound dehiscence, seroma, or hematoma) were determined from the matched patients. RESULTS: 7218 patients on long-term anticoagulation therapy were matched to 7218 patients with no history of anticoagulation therapy. Patients with a history of long-term anticoagulation therapy experienced higher unadjusted rates of non-infectious surgical wound complications (2.15% vs. 1.29%, p < 0.001). No difference in the incidence of surgical site infection was observed between groups (1.73% vs. 1.30%, p = 0.111). After propensity score matching, patients on long-term anticoagulation therapy had higher odds of non-infectious (adjusted odds ratio [aOR]: 1.65, 95% confidence interval [CI] 1.27-2.15, p < 0.001) and infectious (aOR: 1.38, CI 1.05-1.81, p = 0.021) surgical wound complications. CONCLUSION: Long-term anticoagulation therapy confers an independent risk of wound complications among older adults undergoing HA for femoral neck fracture.
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Shabani et al. (2025) conducted a cohort in Femoral neck fracture (n=14,436). Long-term anticoagulation therapy vs. No history of anticoagulation therapy was evaluated on 90-day non-infectious surgical wound complications (wound dehiscence, seroma, or hematoma) (aOR 1.65, 95% CI 1.27-2.15, p=<0.001). Long-term anticoagulation therapy in older adults undergoing hip hemiarthroplasty for femoral neck fracture was associated with increased odds of non-infectious (aOR 1.65) and infectious (aOR 1.38) wound complications.
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