Difference in mortality after hip fracture is associated with postdischarge prescription of antithrombotic prophylaxis: a case-control study.
This study was undertaken to determine whether a prolongation of pharmaceutical antithrombotic prophylaxis beyond hospitalization for hip fracture is associated with a reduced mortality rate. One hundred seventy-nine cases with hip fracture (patients older than 50 years of age) admitted to local general hospitals in 1999 who received postdischarge prescription of any antithrombotic agent (heparin, oral anticoagulants, antiplatelet drugs) and 179 age- and sex-matched patients with hip fracture who did not were included. Postdischarge mortality was assessed at 90 days. Compared with patients who did not receive postdischarge prescription of antithrombotic agents, those who did had an odds ratio of 0.22 (95% confidence interval 0.08-0.59) for all causes of mortality. This result did not change after excluding nonvascular mortality (odds ratio, 0.17; confidence interval, 0.03-0.73; p=0.011). Patients admitted to the hospital for hip fracture are at high risk of death after discharge if they are not given antithrombotic treatment. To substantiate these data, ad hoc prospective randomized trials are needed.
Servizio Farmaceutico, Centro Trombosi, Università di Padova, Italy.
Anna Maria
AM
Grion
Umberto
U
Gallo
Francesca
F
Bano
Michele
M
Ragazzi
Adriano
A
Cestrone
Arturo
A
Orsini
Marina
M
Salomoni
Rosa Maria
RM
Gaion
Vittorio
V
Pengo
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D016022:Case-Control Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006620:Hip Fractures / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D016019:Survival Analysis; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control
D005343:Fibrinolytic Agents