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Impact of anticoagulants in elderly patients who suffer a hip fracture. Should we have a different approach?

机译:抗凝血剂对患有髋部骨折的老年患者的影响。我们应该有不同的方法吗?

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Introduction: Hip fracture in the elderly is a frequent problem. Chronic treatment with anticoagulants is common in these patients, and may delay surgery. Objectives: To compare time to surgery, hospital stay, in-hospital and 90 days complications between anticoagulated (A) and non-anticoagulated (NA) groups. Methods: Retrospective cohort of 64 years-old patients with acute hip fracture. Period June-2014 to December 2019. We estimated crude and adjusted OR (95%CI) for in-hospital complications with logistic regression model. We report the crude and adjusted HR for readmission and 90-day mortality with Cox proportional hazards model. Results: Of the 1058 patients, 123 (11%) were anticoagulated. Time to surgery was 26.4 hours (IIQ 13.9-48) in A and 24 hours (IIQ 2.3-48) in NA, p0.001. Hospital stay was 7 days (IIQ 5-9) in A and 6 days (IIQ 5-10.5) NA, p0,000. In-hospital complications were 17 (14%) in A and 81 (9%) in NA, p0.064. The adjusted OR was 1.53 (95%CI 0.8-2.7) p0.138. For 90-day readmission, the crude HR was 1.51 (95%CI 0.99-2.29) p0.053 and the adjusted HR was 1.31 (95%CI 0.85-2.00) p0,09. For 90-day mortality, the crude HR was 0.80 (95%CI 0.45-1.43) p0.464 and the adjusted HR was 0.70 (95% CI 0.39-1.25) p0.239. Discussion: While we found differences between groups in time to surgery and hospital statistics, their clinical relevance should be reviewed.
机译:介绍:老年人的髋部骨折是常见的问题。患有抗凝血剂的慢性治疗在这些患者中常见,可能会延缓手术。目标:将抗凝(A)和非抗凝(NA)组之间的手术,住院住宿,住院,医院和90天并发症进行比较。方法:64岁急性髋部骨折患者的回顾性队列。期间2014年6月至2019年12月。我们估计粗糙和调整或(95%CI),用于留下物流回归模型。我们向Readly和90天死亡率报告了原油和调整的人力资源,与Cox比例危险模型进行了90天死亡率。结果:1058名患者中,123(11%)抗菌。在NA,P0.001的A和24小时(IIQ 2.3-48)中,手术的时间是26.4小时(IIQ 13.9-48)。住院住宿时间为7天(IIQ 5-9),在A和6天(IIQ 5-10.5)NA,P0,000。在医院的并发症中,在NA,P0.064中的A和81(9%)中是17(14%)。调整或1.53(95%CI 0.8-2.7)P0.138。为90天的阅览,粗rudHR为1.51(95%CI 0.99-29)P0.053,调节的HR为1.31(95%CI 0.85-2.00)P0,09。对于90天的死亡率,粗HR为0.80(95%CI 0.45-1.43)P0.464,调节的HR为0.70(95%CI 0.39-1.25)P0.239。讨论:虽然我们在手术和医院统计数据时发现群体之间的差异,但应审查它们的临床相关性。

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