Impact of anticoagulants in elderly patients who suffer a hip fracture. Should we have a different approach?

Introduction:Hip fracture in the elderly is a frequent problem. Chronic treatment with antico-agulants is common in these patients and may delay surgery. Objectives: To compare time to surgery, hospital stay, in-hospital and 90 days complications between anticoagulated and non-anticoagulated groups. Methods: Retrospective cohort of >64 years-old patients with acute hip fracture. Period June-2014 to December 2019. We estimated crude and adjusted Odds Ratio (95%CI) for in-hospital complications with logistic regression model. We report the crude and adjusted Hazard Ratio for readmission and 90-days mortality with Cox proportional hazards model. Results: Of the 1058 patients, 123 (11%) were anticoagulated. Time to surgery was 26.4 hours (IIQ 13.9-48) in anticoagulated and 24 hours (IIQ 2.3-48) in non-anticoagulated, p 0.001. Hospital stay was 7 days (IIQ 5-9) in anticoagulated and 6 days (IIQ 5-10.5) in non-anticoagulated, p 0,000. In-hospital complications were 17 (14%) in anticoagulated and 81 (9%) in non-anticoagulated, p 0.064. The adjusted o‎r was 1.53 (95%CI 0.8-2.7) p 0.138. For 90-days readmission, the crude HR was 1.51 (95%CI 0.99-2.29) p 0.053 and the adjusted HR was 1.31 (95%CI 0.85-2.00) p0,09. For 90-days mortality, the crude HR was 0.80 (95%CI 0.45-1.43) p 0.464 and the adjusted HR was 0.70 (95% CI 0.39-1.25) p 0.239. Discus-sion: While we found differences between groups in time to surgery and hospital statistics these differences may not be clinically relevant. (www.actabiomedica.it)