title: Effect of early surgery in high surgical risk geriatric patients with femoral neck fracture and taking antiplatelet agents.
abstract: OBJECTIVE
  To investigate the effect of early surgical intervention on the high surgical risk elderly patients who sustained femoral neck fracture (FNF) and taking concomitant antiplatelet agents.
  
  
  METHODS
  Between 2010 and 2012, a prospective study was conducted on 49 geriatric patients, who took antiplatelet agents, sustained FNF and underwent surgery within 72 h [early surgery (ES) group], and these were compared with a retrospective consecutive case series of patients with similar characteristics (45 cases) who had delayed surgery (DS group) after 72 h during an earlier 3-year period. Postoperative outcomes were followed for one year and compared.
  
  
  RESULTS
  There were non-significant differences in perioperative blood loss, blood transfusion, intensive care unit requirement and postoperative mortality (P > 0.05 all). There were 2 patients (4%) in the DS group who died after surgery (P = 0.23). However, the ES group showed a significantly better postoperative outcome in terms of postoperative complications, length of hospital stay, and functional outcome (P < 0.05 all).
  
  
  CONCLUSIONS
  Early hip surgery in geriatric hip fracture patients with ongoing antiplatelet treatment was not associated with a significant increase of perioperative blood loss and postoperative mortality. Moreover, ES resulted in a better postoperative surgical outcome. In early hip surgery protocol, the antiplatelet agents are discontinued and the patient is operated on within 72 h after admission, which is safe and effective for the medically fit patients.
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Paphon
authors.initials: P
authors.lastname: Sa-Ngasoongsong
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Noratep
authors.initials: N
authors.lastname: Kulachote
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Norachart
authors.initials: N
authors.lastname: Sirisreetreerux
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Pongsthorn
authors.initials: P
authors.lastname: Chanplakorn
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Sukij
authors.initials: S
authors.lastname: Laohajaroensombat
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Nithiwut
authors.initials: N
authors.lastname: Pinsiranon
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Patarawan
authors.initials: P
authors.lastname: Woratanarat
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Viroj
authors.initials: V
authors.lastname: Kawinwonggowit
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Chanyut
authors.initials: C
authors.lastname: Suphachatwong
authors.affiliation: Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Pongsthorn Chanplakorn, Sukij Laohajaroensombat, Nithiwut Pinsiranon, Patarawan Woratanarat, Viroj Kawinwonggowit, Chanyut Suphachatwong, Wiwat Wajanavisit, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Wiwat
authors.initials: W
authors.lastname: Wajanavisit
keywords: Antiplatelet agents; Blood loss; Displaced femoral neck fracture; Early hip surgery; Elderly hip fracture; Hip arthroplasty