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- Talk
- 15/06/2021
- Canada
Safety of Expedited Surgical Protocols in Anticoagulated Patients With Hip Fracture: A Systematic Review and Meta-Analysis
Description
In this presentation, Daniel You, a third-year orthopedic surgery resident at the University of Calgary, discusses a crucial research study on the safety of timely surgical protocols for anticoagulated patients suffering from hip fractures. He highlights the challenges of managing surgery timing due to anticoagulant use, emphasizing the significant risks associated with surgical delays, such as increased morbidity and mortality. The talk is centered around a systematic review and meta-analysis designed to assess the impact of timely surgical interventions on patient outcomes, especially focusing on those treated with vitamin K antagonists and direct oral anticoagulants (DOACs).
Daniel underscores the global prevalence of hip fractures and notes that approximately 20% of these patients are on anticoagulants at the time of injury, which complicates surgical decision-making. He presents data showing that anticoagulated patients experience longer delays to surgery, which correlates with higher mortality rates. The systematic review conducted involved a thorough search of clinical literature, leading to the inclusion of multiple studies that evaluate pre- and post-reversal protocols for anticoagulants.
Key findings from the meta-analysis reveal that implementing reversal protocols reduces the time to surgery for vitamin K antagonist patients significantly, with no increase in blood transfusion requirements or thromboembolic complications. The study suggests that timely hip fracture surgery in patients on DOACs is equally safe, showing no increase in 30-day mortality.
Concluding his presentation, Daniel advocates for minimizing surgical delays in patients with pre-injury anticoagulants upon hospital arrival and shares his institution's initiative to develop a timely surgical pathway supported by multidisciplinary teams and research funding aimed at improving patient care outcomes.