title: Clopidogrel therapy--implications for hip fracture surgery.
abstract: It remains unclear whether it is justifiable to delay hip fracture surgery in patients who are taking clopidogrel therapy-to allow the drug's anti-platelet effect to wear off. In a follow-up of 740 consecutive admissions with hip fracture we describe the extent of blood loss and complications in 17 (2.3%) who were taking clopidogrel. The peri-operative fall in haemoglobin was 1.3g/dl (95% CI: 0.4-2.3g/dl) less in the 10 patients in whom the surgeon's policy was for surgery to be delayed for at least 5 days. However, this group also experienced thromboembolic complications that were potentially attributable to this approach. Clopidogrel therapy does have implications for peri-operative blood loss, but hip fracture is a complex and multifactorial condition. We propose an individualised approach to patients taking this increasingly common drug.
authors.affiliation: Trauma Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. antony.johansen@cardiffandvale.wales.nhs.uk
authors.forename: Antony
authors.initials: A
authors.lastname: Johansen
authors.forename: James
authors.initials: J
authors.lastname: White
authors.forename: Adrian
authors.initials: A
authors.lastname: Turk
mesh_terms: D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D000077144:Clopidogrel; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors
chemical_list: D006454:Hemoglobins; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine