Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur
Background. Most orthopaedic units do not have a policy for reversal of anticoagulation in patients with hip fractures. The aim of this study was to examine the current practice in a district general hospital and determine difference in the time to surgery, if any, with cessation of warfarin versus...
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International Scholarly Research Network
2011
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195383/ |
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pubmed-31953832011-11-14 Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur Ashouri, Feras Al-Jundi, Wissam Patel, Akash Mangwani, Jitendra Clinical Study Background. Most orthopaedic units do not have a policy for reversal of anticoagulation in patients with hip fractures. The aim of this study was to examine the current practice in a district general hospital and determine difference in the time to surgery, if any, with cessation of warfarin versus cessation and treatment with vitamin K. Methods. A retrospective review of the case notes between January 2005 and December 2008 identified 1797 patients with fracture neck of femur. Fifty seven (3.2%) patients were on warfarin at the time of admission. Patients were divided into 2 groups (A and B). Group A patients (16/57; 28%) were treated with cessation of warfarin only and group B patients (41; 72%) received pharmacological therapy in addition to stopping warfarin. Time to surgery between the two groups was compared. Results. The mean INR on admission was 2.9 (range 1.7–6.5) and prior to surgery 1.4 (range 1.0–2.1). Thirty eight patients received vitamin K only and 3 patients received fresh frozen plasma and vitamin K. The average time to surgery was 4.4 days in group A and 2.4 days in group B. The difference was statistically significant (P < .01). Conclusion. Reversal of high INR is important to avoid significant delay in surgery. There is a need for a national policy for reversing warfarin anticoagulation in patients with hip fractures requiring surgery. Vitamin K is safe and effective for anticoagulation reversal in hip fracture patients. International Scholarly Research Network 2011 2011-02-24 /pmc/articles/PMC3195383/ /pubmed/22084696 http://dx.doi.org/10.5402/2011/294628 Text en Copyright © 2011 Feras Ashouri et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Ashouri, Feras Al-Jundi, Wissam Patel, Akash Mangwani, Jitendra |
| spellingShingle |
Ashouri, Feras Al-Jundi, Wissam Patel, Akash Mangwani, Jitendra Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur |
| author_facet |
Ashouri, Feras Al-Jundi, Wissam Patel, Akash Mangwani, Jitendra |
| author_sort |
Ashouri, Feras |
| title |
Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur |
| title_short |
Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur |
| title_full |
Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur |
| title_fullStr |
Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur |
| title_full_unstemmed |
Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur |
| title_sort |
management of warfarin anticoagulation in patients with fractured neck of femur |
| description |
Background. Most orthopaedic units do not have a policy for reversal of anticoagulation in patients with hip fractures. The aim of this study was to examine the current practice in a district general hospital and determine difference in the time to surgery, if any, with cessation of warfarin versus cessation and treatment with vitamin K. Methods. A retrospective review of the case notes between January 2005 and December 2008 identified 1797 patients with fracture neck of femur. Fifty seven (3.2%) patients were on warfarin at the time of admission. Patients were divided into 2 groups (A and B). Group A patients (16/57; 28%) were treated with cessation of warfarin only and group B patients (41; 72%) received pharmacological therapy in addition to stopping warfarin. Time to surgery between the two groups was compared. Results. The mean INR on admission was 2.9 (range 1.7–6.5) and prior to surgery 1.4 (range 1.0–2.1). Thirty eight patients received vitamin K only and 3 patients received fresh frozen plasma and vitamin K. The average time to surgery was 4.4 days in group A and 2.4 days in group B. The difference was statistically significant (P < .01).
Conclusion. Reversal of high INR is important to avoid significant delay in surgery. There is a need for a national policy for reversing warfarin anticoagulation in patients with hip fractures requiring surgery. Vitamin K is safe and effective for anticoagulation reversal in hip fracture patients. |
| publisher |
International Scholarly Research Network |
| publishDate |
2011 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195383/ |
| _version_ |
1611481667079241728 |