Variables to Predict Mortality in Hip Fractures in Patients Over 65 Years of Age: A Study on the Role of Anticoagulation as a Risk Factor

The objective of this research was to study the possible relationship between the consumption of dicoumarinic agents (understanding the consumption of acenocoumarol as regulated and monitored anticoagulation) and the mortality rate in people older than 65 years undergoing a hip fracture (HF) interve...

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Bibliographic Details
Published in:	Journal of trauma nursing Vol. 24; no. 5; pp. 326 - 334
Main Authors:	Sarabia-Cobo, Carmen M, Sáenz-Jalón, María, Vélez-Carrera, Begoña, Miguel Martín, M Eugenia, Rodríguez Landeras, Gema, Roscales San Bartolomé, Elena, Santiago Fernández, Marta, Higuero-Piris, Carmen, Artabe Pozas, Patricia, Espeso Salas, Sandra, Briz Casares, Sonia
Format:	Journal Article
Language:	English
Published:	United States 01-09-2017
Subjects:	Acenocoumarol - administration & dosage Acenocoumarol - adverse effects Age Factors Aged Aged, 80 and over Anticoagulants - administration & dosage Anticoagulants - adverse effects Cause of Death Cohort Studies Female Follow-Up Studies Fracture Fixation, Internal - methods Fracture Fixation, Internal - mortality Geriatric Assessment Hip Fractures - diagnosis Hip Fractures - drug therapy Hip Fractures - mortality Hip Fractures - surgery Humans Length of Stay Male Nursing Reference Values Retrospective Studies Risk Assessment Sex Factors Survival Rate Treatment Outcome
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Summary:	The objective of this research was to study the possible relationship between the consumption of dicoumarinic agents (understanding the consumption of acenocoumarol as regulated and monitored anticoagulation) and the mortality rate in people older than 65 years undergoing a hip fracture (HF) intervention. It was a retrospective, observational and descriptive study. Nine hundred fifty-seven patients were included who underwent an intervention for HF between the years 2012 and 2014 in a third-level hospital. Patients took acenocoumarol (16.1%), which compared with nonanticoagulated patients took longer in receiving intervention, they remained hospitalized for more days, and they presented greater mortality within the first year after the intervention. Likewise, those who presented greater risk according to the classification system used by the American Society of Anesthesiologists (ASA) to estimate the risk of anesthesia for the different states of the patients who were anticoagulated also suffered greater mortality. The next factors increased the mortality in the first year: advanced age, delayed surgery, male sex, need for transfusion, high international normalized ratio, consumption of acenocoumarol, and a high ASA risk. We concluded the consumption of acenocoumarol increased the risk of mortality within the first year after surgery in 1.3 of possible cases. Other risk factors that also independently increased the risk of mortality included advanced age, male sex, delayed surgery, the need for transfusions, and surgical risk (for high levels in the ASA classification).
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 ObjectType-Feature-1
ISSN:	1078-7496
DOI:	10.1097/JTN.0000000000000313