title: Complications of hip fracture surgery on patients receiving clopidogrel therapy.
abstract: BACKGROUND
  Clopidogrel (Plavix(®)) may influence patient safety during fracture surgery. Our study examines the incidence of complications for patients undergoing hemiarthroplasty on clopidogrel therapy.
  
  
  METHODS
  All patients, who underwent hemiarthroplasty between 2005 and 2011 were retrospectively reviewed. Patients were placed in two comparative groups based on the use of clopidogrel antiplatelet therapy. Records were reviewed for patient demographics, ASA score, pre and postoperative hemoglobin, time to surgery, length of stay, bleeding events, transfusions and complications. Comparative statistical analysis was performed using Fisher's exact test and Student's t test, using P < 0.05 to identify statistical significance.
  
  
  RESULTS
  A total of 203 charts were reviewed, of which 162 patients met inclusion/exclusion criteria. One hundred and twelve females and 50 males with mean age of 84 years were identified. The clopidogrel group consisted of 15 (9.3 %) patients and the nonclopidogrel group 147 (90.7 %). The clopidogrel group had more comorbidities resulting in a significantly higher ASA score (3.9 vs. 2.9), and lower preoperative hemoglobin (11.3 vs. 12.0). There was no significant difference identified in time to surgery, intraoperative blood loss, hemoglobin on days 1-3, or number of transfusions received between groups. Patients on clopidogrel were seen to have significantly longer hospital stays (10.6 vs. 7.4 days). However, a similar rate of wound and bleeding related complications (6.7 vs. 6.1 %) was seen.
  
  
  CONCLUSIONS
  The optimal treatment for hip fracture patients on antiplatelet therapy is unclear. However, in this study there appears to be no significant difference with regards to bleeding and bleeding related wound complications, suggesting it is safe to proceed with hemiarthroplasty for patients receiving clopidogrel.
authors.affiliation: Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, New Brunswick, NJ, 08901, USA, manaqib786@yahoo.com.
authors.forename: Moiz I
authors.initials: MI
authors.lastname: Manaqibwala
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Butler
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Sagebien
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000077144:Clopidogrel; D005260:Female; D062785:Hemiarthroplasty / Q000009:adverse effects*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000209:etiology*; D012189:Retrospective Studies; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine