Preinjury warfarin and geriatric orthopedic trauma patients: A case-matched study

被引:14
作者
Kirsch, MJ
Vrabec, GA
Marley, RA
Salvator, AE
Muakkassa, FF
机构
[1] Akron Gen Med Ctr, Dept Orthopaed Surg, Akron, OH 44307 USA
[2] Akron Gen Med Ctr, Dept Trauma, Akron, OH 44307 USA
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 2004年 / 57卷 / 06期
关键词
orthopedics; warfarin; fractures; geriatric; trauma; anticoagulation;
D O I
10.1097/01.TA.0000150839.69648.17
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: This study examined the hypothesis that patients on warfarin before sustaining orthopedic injuries will have increased morbidity and mortality compared with matched control patients not on warfarin. Methods: Records of consecutive trauma patients on warfarin with orthopedic fractures who presented from January 1997 to June 2002 to a Level I trauma center were retrospectively analyzed. Data were evaluated using the chi(2) and Student's t tests and nonparametric tests when appropriate; values of p < 0.05 were considered significant. Results: A study group of 53 patients was available for review. In comparison with the control group, significant differences were found in time delay from admission to surgery (p = 0.005), hospital length of stay (p = 0.03), total units of blood transfused (p = 0.03), and discharge disposition (p < 0.0003). No difference was found in number of intensive care unit days, complications, or mortality. Conclusion: Preinjury warfarin impacts outcomes of geriatric trauma patients sustaining orthopedic injuries.
引用
收藏
页码:1230 / 1233
页数:4
相关论文
共 11 条
[1]   Managing oral anticoagulant therapy [J].
Ansell, J ;
Hirsh, J ;
Dalen, J ;
Bussey, H ;
Anderson, D ;
Poller, L ;
Jacobson, A ;
Deykin, D ;
Matchar, D .
CHEST, 2001, 119 (01) :22S-38S
[2]   Outcomes of anticoagulated trauma patients [J].
Ferrera, PC ;
Bartfield, JM .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1999, 17 (02) :154-156
[3]   The risk for and severity of bleeding complications in elderly patients treated with warfarin [J].
Fihn, SD ;
Callahan, CM ;
Martin, DC ;
McDonell, MB ;
Henikoff, JG ;
White, RH .
ANNALS OF INTERNAL MEDICINE, 1996, 124 (11) :970-+
[4]   Management of anticoagulation before and after elective surgery [J].
Kearon, C ;
Hirsh, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 336 (21) :1506-1511
[5]   Impact of preinjury warfarin use in elderly trauma patients [J].
Kennedy, DM ;
Cipolle, MD ;
Pasquale, MD ;
Wasser, T .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2000, 48 (03) :451-453
[6]  
MAYO NE, 1993, ARCH PHYS MED REHAB, V74, P917
[7]   TRAUMA AND ORAL ANTI-COAGULANT [J].
OMARA, K ;
MAVICHAK, V .
ANNALS OF EMERGENCY MEDICINE, 1983, 12 (11) :700-703
[8]  
SCHWAB CW, 2000, TRAUMA, P1099
[9]   FALL-RELATED INJURIES IN ANTICOAGULATED STROKE PATIENTS DURING INPATIENT REHABILITATION [J].
STEIN, J ;
VIRAMONTES, BE ;
KERRIGAN, DC .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1995, 76 (09) :840-843
[10]   RISK-FACTORS FOR FALLS AMONG ELDERLY PERSONS LIVING IN THE COMMUNITY [J].
TINETTI, ME ;
SPEECHLEY, M ;
GINTER, SF .
NEW ENGLAND JOURNAL OF MEDICINE, 1988, 319 (26) :1701-1707