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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Is discontinuation of clopidogrel necessary for intracapsular hip fracture surgery? Analysis of 102 hemiarthroplasties
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Is discontinuation of clopidogrel necessary for intracapsular hip fracture surgery? Analysis of 102 hemiarthroplasties

机译：包膜内髋部骨折手术是否需要停用氯吡格雷？ 102例半髋关节置换术的分析

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class="Heading">Background class="Para">An increasing number of elderly patients are managed with long-term antiplatelet therapy. Such patients often present with hip fracture requiring surgical intervention and may be at increased risk of perioperative bleeding and complications. The aim of this study was to ascertain whether it is necessary to stop clopidogrel preoperatively to avoid postoperative complications following hip hemiarthroplasty surgery in patients with intracapsular hip fracture. class="Heading">Materials and methods class="Para">A retrospective review of 102 patients with intracapsular hip fracture with either perioperative clopidogrel therapy [clopidogrel group (CG)] or no previous clopidogrel exposure [no clopidogrel group (NCG)] who underwent hip hemiarthroplasty surgery was undertaken. Statistical comparison on pre- and postoperative haemoglobin, American Society of Anesthesiologists (ASA) grade, comorbidities, operative time, transfusion requirements, hospital length of stay (LOS), wound infection, haematoma and reoperation rate between the two groups was undertaken. Regression analysis was undertaken to ascertain the risk ratios (RR) of complications and transfusion associated with clopidogrel. class="Heading">Results class="Para">There was no difference with respect to ASA grade, comorbidities (except cardiac comorbidities), pre- and postoperative haemoglobin levels, operation time, age or gender between the two groups. Four and two patients, respectively, required transfusion postoperatively in the CG and NCG (p?=?0.37). There was no difference with respect to LOS, wound infection, haematoma or reoperation rate between the two groups postoperatively. The covariate-adjusted RR for complications and transfusion while being on clopidogrel were 0.43 [95?% confidence interval (CI) 0.07–2.60] and 3.96 (95?% CI 0.40–39.68), respectively. class="Heading">Conclusion class="Para">Continuing clopidogrel therapy throughout the perioperative period in patients with intracapsular hip fracture is not associated with an increased risk of complications following hip hemiarthroplasty surgery.
机译：class =“ Heading”>背景 class =“ Para”>越来越多的老年患者接受长期抗血小板治疗。此类患者经常出现髋部骨折，需要手术干预，并且可能会增加围手术期出血和并发症的风险。这项研究的目的是确定是否有必要在术前停止使用氯吡格雷，以避免囊内髋部骨折患者髋部半髋置换术后并发症的发生。 class =“ Heading”>材料和方法 class =“ Para”>对102例接受围手术期氯吡格雷治疗[氯吡格雷组（CG）]或既往无氯吡格雷暴露[无氯吡格雷组（NCG）]的患者进行了髋部半髋关节置换手术的回顾性研究。 。两组之间进行了术前和术后血红蛋白，美国麻醉医师学会（ASA）等级，合并症，手术时间，输血要求，住院时间（LOS），伤口感染，血肿和再手术率的统计比较。进行回归分析以确定与氯吡格雷相关的并发症和输血的风险比（RR）。 class =“ Heading”>结果 class =“ Para”>与两组之间的ASA等级，合并症（心脏合并症除外），术前和术后血红蛋白水平，手术时间，年龄或性别有关。分别有4名和2名患者术后需要在CG和NCG中输血（ p ？=？0.37）。两组术后LOS，伤口感染，血肿或再次手术率无差异。经氯吡格雷治疗时并发症和输血的经协变量调整的RR分别为0.43 [95％置信区间（CI）0.07-2.60]和3.96（95％CI 0.40-39.68）。 class = “ Heading”>结论 class =“ Para”>在包膜内髋骨骨折患者的整个围手术期继续使用氯吡格雷与髋关节半髋置换术后并发症的风险增加无关。

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