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Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio

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Department of Orthopaedic Surgery, Boston Medical Center, 850 Harrison Avenue, Boston, MA 02118, USA
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Orthopaedic and Rehabilitation Centers, 5616 North Western Avenue, Chicago, IL 60659, USA
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Ortho Montana, 2900 12th Avenue North, Billings, MT 59101, USA
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Department of Orthopaedic Surgery, Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805, USA
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Reno Orthopaedic Clinic, Reno, NV 89503, USA
*
Author to whom correspondence should be addressed.
Geriatrics 2020, 5(3), 43; https://doi.org/10.3390/geriatrics5030043
Received: 24 April 2020 / Revised: 9 July 2020 / Accepted: 10 July 2020 / Published: 15 July 2020
(This article belongs to the Special Issue Orthopaedic Surgery and Rehabilitation in the Aging Population)
In current clinical practice, orthopedic surgeons often delay the surgery intervention on geriatric hip fracture patients to optimize the international normalized ratio (INR), in order to decrease the risk of postoperative hematological complications. However, some evidence suggests that full reversal protocols may not be necessary, especially for patients with prior thromboembolic history. Our study aims to compare the surgical outcomes of patients with normal versus elevated INR values. We conducted a retrospective chart review on 217 patients who underwent surgeries on hip fractures at two academic trauma centers. We found that in our group (n = 124) of patients with an INR value of 1.5–3.0, there was only one reoperation for a hematoma, but there was a trend for more blood transfusions. There was no statistically significant difference in the odds of reoperation or overall complications. Nevertheless, there were significantly more events of postoperative anemia in this high INR patient group. View Full-Text
Keywords: hip fracture; INR; anticoagulation; postoperative complications hip fracture; INR; anticoagulation; postoperative complications
MDPI and ACS Style

Kain, M.S.; Saper, D.; Lybrand, K.; Bramlett, K.-J.; Tornetta III, P.; Althausen, P.; Garfi, J.S.; Willier III, D.P.; Niu, R.; Marcantonio, A.J. Postoperative Complications of Hip Fractures Patients on Chronic Coumadin: A Comparison Based on Operative International Normalized Ratio. Geriatrics 2020, 5, 43.

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