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 frac- ture patients and how this has changed over time. We investigated temporal trends in—and factors associated with—the use of anti- thrombotics 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 specifi cally, 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 anti- thrombotics to ensure safe surgery and to avoid surgical delay.