Prompt surgical treatment for intertrochanteric fracture in patients receiving clopidogrel

Abstract

Objective To explore the safety of hip fracture surgery in the aged patients who are taking clopidogrel at the time of surgery. Methods A retrospective study was performed to analyze the 238 aged patients with femoral intertrochanteric fracture who had received femoral proximal intramedullary nailing between January 2012 and December 2013. Of them, 32 took oral clopidogrel for a long time and did not stop the medication at the time of surgery while 206 never used clopidogrel. The American Society of Anesthesiologists(ASA)score, combined post-artery stenting and coronary atherosclerotic cardiopathy in the clopidogrel group were significantly higher than in the non-clopidogrel group(P< 0. 05). The 2 groups were compared in terms of operation time, ICU time, postoperative hemoglobin, hospital stay, postoperative transfusion, local and general complications, and mortality. Results There were no significant differences between the 2 groups in operation time, intraoperative bleeding, postoperative drainage volume, postoperative hemoglobin, or postoperative transfusion(P> 0. 05). The ICU time(1. 7 ±0. 9 d)and hospital stay(12. 5 ±2. 5 d)for the clopidogrel group were significantly longer than for the clopidogrel group(0. 9 ±0. 5 d、9. 3 ±1. 9 d)( P 0. 05). Conclusion It is safe to perform prompt surgical treatment of hip fracture for aged patients receiving clopidogrel. Key words: Hip fractures; Clopidogrel; Fracture fixation, intramedullary; Bone nails; Postoperative complication