Anticoagulation as a Risk Factor of mortality in patients with hip fractures

30 de September de 2017

Every year there are between 50,000 and 60,000 hip fractures with an annual incidence of 100 cases / 100,000 inhabitants in Spain. The most affected patients are usually elderly at about 80 years of age and three out of four are women.

Most hip fractures are solved with surgery as soon as possible. There are many studies that relate delayed intervention with increased mortality and morbidity.

Members of IDIVAL Nursing research group have just published a study carried out in the surgical area of Valdecilla Hospital to study a risk factor that has not been investigated to date: how patients with anticoagulant treatment (Sintrom® the most employed) they see the evolution of their affected prognosis. The main objective of this study was to study the possible relationship between the consumption of dicoumarinic agents (understanding the consumption of acenocoumarol as regulated and monitored anticoagulation) and the mortality rate in people older than 65 years undergoing a hip fracture (HF) intervention. 

The study concluded the consumption of acenocoumarol increased the risk of mortality within the first year after surgery in 1.3 of possible cases. Other risk factors that also independently increased the risk of mortality included advanced age, male sex, delayed surgery, the need for transfusions, and surgical risk (for high levels in the ASA classification).

Therfore, it could be suggested that early surgical intervention after hip fracture, as well as adequate anticoagulant control may contribute to reduce mortality in older people with hip fracture. Understanding the causes of increased patient mortality with these factors is posed as a future challenge that may help better clinical management.

Reference: Sarabia-Cobo CM, Sáenz-Jalón M, Vélez-Carrera B, Miguel Martín ME, Rodríguez Landeras G, Roscales San Bartolomé E, Santiago Fernández M, Higuero-Piris C, Artabe Pozas P, Espeso Salas S, Briz Casares S. Variables to Predict Mortality in Hip Fractures in Patients Over 65 Years of Age: A Study on the Role of Anticoagulation as a Risk Factor. J Trauma Nurs. 2017 Sep/Oct;24(5):326-334. doi: 10.1097/JTN.0000000000000313. PubMed PMID: 28885525.