Platelet mapping in patients with hip fracture and chronic ingestion of antiaggregants that require surgical treatment

Platelet mapping in patients with hip fracture and chronic ingestion of antiaggregants that require surgical treatment

Author: 
Yoalli Gómez-Guerrero and Luis Gerardo Motta-Amézquita
Abstract: 

Background: There are currently a large number of elderly patients with hip fracture who require surgical treatment; However, it can be delayed by the intake of antiaggregants, which justifies the present study to avoid delaying the definitive treatment and thus reduce the associated morbidity and mortality.
Objective: To establish the behavior of platelet mapping in patients with chronic intake of antiaggregants that have required surgical treatment for hip fracture.
Methods: 51 patients were included in the HOSGEAES from 2015 to 2016. They were divided into three groups: A. Acetylsalicylic acid (n = 22), B. Clopidogrel (n = 22) and C. Dual therapy (n = 7). The universal variables were recorded, coagulation tests result of platelet mapping and percentage of inhibition. The analysis of variance was applied to compare three or more means, Chi square or Fisher's exact test. The data were processed with the SPSS 17 package, p <0.05 was taken as statistical significance.
Results The abnormal platelet mapping rate was 62.7% vs 37.3% normal. The most unfavorable antiaggregant was dual therapy, 54.5% in those taking acetylsalicylic acid (p = 0.02). The presence of Arterial Hypertension was significantly associated with normal platelet mapping (p = 0.01); In the stratified analysis, it was observed that 100% of the patients in group C had SAH and abnormal platelet mapping compared to 55% in group B and 44.4% in those in group A (p = 0.03).
Conclusions 19 patients (37.3%) resulted with normal platelet mapping, 10 patients belong to group A (19.7%), 9 patients (17.7%) to group B; therefore, they can be operated on for the hip fracture without further delaying the procedure. The combination of acetylsalicylic acid with clopidogrel (group C) should be carefully evaluated since it alters platelet mapping in 100% of cases. The presence of Arterial Hypertension is an important covariate associated to both the mapping alteration and the combined use of both drugs.

 

Paper No: 
1884