title: Surgical delay in acute admissions on warfarin: are we doing enough?
abstract: Warfarin anti-coagulation can cause significant delay in acute surgical admissions. We reviewed fracture neck of femur patients operated over a period of 4 years in our unit. There was an average delay to surgery of 4.36 days in patients on warfarin as against an average delay of 1.78 days in patients not on warfarin (p < 0.001). The review was followed up with a questionnaire-based survey of consultant haematologists, and a general agreement towards a protocol-based use of vitamin K(1) was noted. The reasons for limited use of vitamin K(1) include the lack of studies and guidelines specifically addressing the pre-operative emergency admissions. We highlight a practical problem shared across different specialities and identify the areas for future studies.
authors.affiliation: Department of Orthopaedics, Wrexham Maelor Hospital, UK. smiraj@rediffmail.com
authors.forename: R
authors.initials: R
authors.lastname: Bansal
authors.forename: D K
authors.initials: DK
authors.lastname: Watson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D004630:Emergencies; D004812:Epidemiologic Methods; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D013997:Time Factors; D006113:United Kingdom; D010837:Vitamin K 1 / Q000627:therapeutic use; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D010837:Vitamin K 1