Key result
Aspirin should be continued throughout the peri-operative period for geriatric patients undergoing hip fracture surgery, while management of dual anti-platelet therapy requires individualized clinical judgment.
This review highlights the need for individualized, multidisciplinary peri-operative management of anti-platelet and anti-thrombotic therapies in geriatric hip fracture patients to balance bleeding and thrombotic risks.
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May inform individualized antithrombotic decisions in geriatric hip fracture surgery; leaves open need for prospective trials to guide practice.
Hip fractures are common events in the geriatric population and are often associated with significant morbidity and mortality. Over the coming decades, the size of the greying population is forecast to increase and hence, the annual incidence of hip fracture is expected to rise substantially. Several studies have shown that hip fracture surgery performed within 24 to 48 h of hospitalisation significantly reduces mortality. Medical specialists including cardiologists are often involved in the care of these geriatric patients as most of them have comorbid conditions that must be managed concomitantly with their fracture. Cardiovascular and thromboembolic complications are among some of the commonest adverse events that could be experienced by these elderly patients during hospitalisation. We review in this article the current recommendations and controversies on the peri-operative management of anti-platelet agents and anti-thrombotic agents in geriatric patients undergoing semi-urgent hip fracture surgery.
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Ho et al. (2010) conducted a review in Hip fracture in geriatric patients. Peri-operative management of anti-platelet and anti-thrombotic agents was evaluated. Aspirin should be continued throughout the peri-operative period for geriatric patients undergoing hip fracture surgery, while management of dual anti-platelet therapy requires individualized clinical judgment.
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