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Semin Thromb Hemost 2019; 45(02): 164-170
DOI: 10.1055/s-0039-1678718
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Patients Taking Oral Anticoagulants Who Need Urgent Surgery for Hip Fracture

Elvira Grandone
1   Fondazione, “Casa Sollievo della Sofferenza,” S. Giovanni Rotondo, Foggia, Italy
2   Ob/Gyn Department of The First I.M. Sechenov Moscow State Medical University, Moscow, Russian Federation
,
Angelo Ostuni
3   UOC Medicina Trasfusionale, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy
,
Giovanni L. Tiscia
1   Fondazione, “Casa Sollievo della Sofferenza,” S. Giovanni Rotondo, Foggia, Italy
,
Francesco Marongiu
4   Dipartimento di Scienze Mediche Internistiche, University of Cagliari, Cagliari, Italy
,
Doris Barcellona
4   Dipartimento di Scienze Mediche Internistiche, University of Cagliari, Cagliari, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
11 February 2019 (online)

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Abstract

The number of hip fractures in anticoagulated patients is predicted to increase, due to people living longer. However, evidence regarding urgent perioperative management of elderly patients with hip fracture who take oral anticoagulants (vitamin K antagonists or direct oral anticoagulants) is scarce. In this article, the authors present a narrative review of the evidence to date supporting the urgent management of hip fracture in anticoagulated elderly patients. They discuss the complexity of managing the high risk of procedure-related bleeding and, at the same time, the high risk of thromboembolism. The role of a bridging procedure and the best strategy of anticoagulation reversal are also reviewed. Further studies are required to improve the evidence in urgent surgery, especially in frail elderly patients.

Keywords

anticoagulants - hip fractures - venous thromboembolism - hemorrhage - aged - emergencies

Source of Support

No source of support was provided for this paper.


 

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