Key result
A narrative review highlights the complexity of balancing bleeding and thromboembolic risks during urgent hip fracture surgery in anticoagulated elderly patients, noting a scarcity of evidence.
Why the study?
Evidence regarding urgent perioperative management of elderly patients with hip fracture taking oral anticoagulants is scarce despite an expected increase in these cases.
There is a lack of robust evidence guiding the perioperative management of oral anticoagulants in elderly patients requiring urgent hip fracture surgery, highlighting the need for further studies.
Answers are grounded in this paper and cite their sources.
Evidence gaps preclude firm perioperative anticoagulant guidance in urgent hip fracture surgery; leaves open optimal risk-balance strategies pending prospective trials.
The number of hip fractures in anticoagulated patients is predicted to increase, due to people living longer. However, evidence regarding urgent perioperative management of elderly patients with hip fracture who take oral anticoagulants (vitamin K antagonists or direct oral anticoagulants) is scarce. In this article, the authors present a narrative review of the evidence to date supporting the urgent management of hip fracture in anticoagulated elderly patients. They discuss the complexity of managing the high risk of procedure-related bleeding and, at the same time, the high risk of thromboembolism. The role of a bridging procedure and the best strategy of anticoagulation reversal are also reviewed. Further studies are required to improve the evidence in urgent surgery, especially in frail elderly patients.
No takes yet. Share an insight, caveat, or question.
Ostuni et al. (2019) conducted a review in Hip fracture in patients taking oral anticoagulants. Urgent perioperative management (bridging procedures and anticoagulation reversal) was evaluated. A narrative review highlights the complexity of balancing bleeding and thromboembolic risks during urgent hip fracture surgery in anticoagulated elderly patients, noting a scarcity of evidence.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: