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Preoperative platelet and international normalized ratio thresholds and risk of complications after primary hip fracture surgery

Journal of the American Academy of Orthopedic Surgeons Apr 14, 2021

Varady NH, Yeung CM, Amen TB, et al. - The present study was performed to distinguish the risk of 30-day postoperative morbidity and mortality in patients with thrombocytopenia or elevated international normalized ratio (INR) undergoing hip fracture surgery. Researchers assessed the National Surgical Quality Improvement Program database for patients undergoing surgical treatment of a native hip fracture from 2012 to 2017 (N = 86,850). They obtained patient demographic, laboratory, and complication data. The study enrolled a sum of 72,306 and 56,027 patients for analysis of preoperative platelet and INR levels, respectively. The outcomes of this study imply that preoperative platelet thresholds of < 100,000/μL and INR thresholds of 1.5 serve as important risk factors for complications after hip fracture surgery. Further study is needed to ascertain if preoperative platelet transfusions and/or INR reversal will improve outcomes for these patients.

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