Temporal trends in the use of antithrombotics at admission.
Background and purpose - Currently, no clear evidence exists on the pattern of use of antithrombotics at admission in hip fracture patients and how this has changed over time. We investigated temporal trends in-and factors associated with-the use of antithrombotics in patients admitted with a fractured hip. Patients and methods - This was a population-based cohort study including all patients aged 18 years or above who were admitted with a hip fracture in Denmark from 1996 to 2012. The Danish national registries were used to collect information on medication use, vital status, and comorbidity. Results - From 1996 to 2012, the proportion of patients using antithrombotics in general increased by a factor of 2.3 from 19% to 43% (p < 0.001). More specifically, the use of anticoagulants increased by a factor of 6.8 and the use of antiplatelets increased by a factor of 2.1. When we adjusted for possible confounders, the use of antithrombotics still increased for every calendar year (relative risk (RR) = 1.03, CI: 1.03-1.04; p < 0.001). Age, sex, and Charlson comorbidity index were all associated with the use of antithrombotics (all p < 0.001). Interpretation - The proportion of hip fracture patients using antithrombotics at admission has increased substantially in Denmark over the last 2 decades. This highlights the need for evidence-based guidelines on how to handle patients using antithrombotics to ensure safe surgery and to avoid surgical delay.
a Department of Orthopaedic Surgery , Bispebjerg Hospital, University of Copenhagen ;
Christian Medom
CM
Madsen
a Department of Orthopaedic Surgery , Bispebjerg Hospital, University of Copenhagen ;
Christopher
C
Jantzen
a Department of Orthopaedic Surgery , Bispebjerg Hospital, University of Copenhagen ;
Jes Bruun
JB
Lauritzen
b Department of Medicine , Holbæk Hospital , Holbæk ;|c Odense Patient Data Explorative Network, University of Southern Denmark , Odense ;
Bo
B
Abrahamsen
d Department of Clinical Biochemistry , Bispebjerg Hospital, University of Copenhagen , Denmark.
Henrik L
HL
Jorgensen
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D010343:Patient Admission; D011159:Population Surveillance; D012042:Registries; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
D000925:Anticoagulants