PDF(Pubmed)
Abstract：
This study aimed to examine the incidence rate of early reoperations following hip fracture surgery and determine the safety of resuming direct oral anticoagulants. Many orthopedic surgeons are reluctant to resume chronic anticoagulation therapy for patients after surgical intervention for hip fractures. One of the main reasons is the potential for reoperation in the case of surgical complications. We conducted a retrospective cohort study at an Academic Level I trauma center, reviewing the records of 425 geriatric patients (age > 60) who underwent hip fracture surgery between 2018 and 2020, including a subgroup treated with direct oral anticoagulants prior to hospitalization. The study assessed the incidence rate of complications requiring early reoperation. Out of the 425 patients, only nine (2%) required reoperation within a month after discharge, with two (0.5%) on chronic anticoagulation therapy. None of the reoperations were urgent, and all were performed at least 24 h after re-admission. The findings revealed a very low incidence rate of reoperations in patients who underwent hip fracture surgery, with no reoperations performed within 24 h of re-admission. Consequently, we believe that resuming chronic direct oral anticoagulants is a safe and effective approach when discharging patients after hip fracture surgery.
摘要：
这项研究旨在检查髋部骨折手术后早期再次手术的发生率，并确定恢复直接口服抗凝药的安全性。对于髋部骨折手术干预后的患者，许多骨科医生不愿恢复慢性抗凝治疗。主要原因之一是在手术并发症的情况下可能再次手术。我们在学术一级创伤中心进行了一项回顾性队列研究，回顾了在2018年至2020年期间接受髋部骨折手术的425例老年患者(年龄>60岁)的记录,包括住院前接受直接口服抗凝药治疗的亚组.该研究评估了需要早期再次手术的并发症的发生率。在425名患者中，出院后一个月内只有9人(2%)需要再次手术，2例（0.5%）接受慢性抗凝治疗。再手术都不是紧急的,所有患者均在再次入院后至少24小时进行。研究结果表明，接受髋部骨折手术的患者再次手术的发生率非常低，在重新入院后24小时内没有再次手术。因此,我们认为，在髋部骨折手术后出院时，恢复慢性直接口服抗凝药是一种安全有效的方法。
