title: Safety of clopidogrel in hip fracture surgery.
abstract: OBJECTIVE
  To compare postoperative outcomes of hip fracture surgery in patients who were and were not taking clopidogrel at the time of surgery.
  
  
  METHODS
  Using the Rochester Epidemiology Project database, we performed a population-based, retrospective cohort study comparing patients who were and were not taking clopidogrel at the time of hip fracture surgery between January 1, 1996, and June 30, 2010. Primary outcomes were perioperative bleeding and mortality. Secondary outcomes were perioperative thrombotic events.
  
  
  RESULTS
  During the study period, 40 residents of Olmsted County, Minnesota (median age, 83 years), who were taking clopidogrel underwent hip fracture repair. These 40 patients were matched 2:1 with 80 control patients (median age, 84 years). The groups were similar in age, sex, American Society of Anesthesiologists score, type of surgical procedure, and use of deep venous thrombosis prophylaxis. The mean time from admission to surgery was less than 36 hours for each cohort. Perioperative bleeding complications and mortality were not significantly different between patients who were and were not taking clopidogrel at the time of hip fracture surgery. Combined bleeding outcome criteria was met in 48% of the clopidogrel cohort and 45% of the control cohort (relative risk, 1.06; 95% CI, 0.70-1.58; P=.80). One-year mortality was 28% in the clopidogrel cohort and 29% in the control cohort (hazard ratio, 1.33; 95% CI, 0.84-2.12; P=.23).
  
  
  CONCLUSIONS
  Although the small sample size precludes making a definitive conclusion, we found no evidence that prompt surgical treatment of hip fracture in patients taking clopidogrel compromises perioperative outcomes.
authors: Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. feely.molly@mayo.edu
authors: Molly A
authors: MA
authors: Feely
authors: Tad M
authors: TM
authors: Mabry
authors: Christine M
authors: CM
authors: Lohse
authors: Stephen A
authors: SA
authors: Sems
authors: Karen F
authors: KF
authors: Mauck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D000077144:Clopidogrel; D015331:Cohort Studies; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008910:Minnesota; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D011184:Postoperative Period; D012189:Retrospective Studies; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
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