Department of Cardiology, Tan Tock Seng Hospital, 11, Jalan Tan Tock Seng, Singapore, Singapore.
Osteoporos Int. 2010 Dec;21(Suppl 4):S573-7. doi: 10.1007/s00198-010-1416-x. Epub 2010 Nov 6.
Hip fractures are common events in the geriatric population and are often associated with significant morbidity and mortality. Over the coming decades, the size of the greying population is forecast to increase and hence, the annual incidence of hip fracture is expected to rise substantially. Several studies have shown that hip fracture surgery performed within 24 to 48 h of hospitalisation significantly reduces mortality. Medical specialists including cardiologists are often involved in the care of these geriatric patients as most of them have comorbid conditions that must be managed concomitantly with their fracture. Cardiovascular and thromboembolic complications are among some of the commonest adverse events that could be experienced by these elderly patients during hospitalisation. We review in this article the current recommendations and controversies on the peri-operative management of anti-platelet agents and anti-thrombotic agents in geriatric patients undergoing semi-urgent hip fracture surgery.
髋部骨折在老年人群中很常见,常伴有较高的发病率和死亡率。在未来几十年,人口老龄化的规模预计会增加,因此髋部骨折的年发病率预计会大幅上升。多项研究表明,在住院后 24 至 48 小时内进行髋部骨折手术可显著降低死亡率。包括心脏病专家在内的医学专家经常参与这些老年患者的治疗,因为他们大多数人都有合并症,必须与骨折同时进行管理。心血管和血栓栓塞并发症是这些老年患者在住院期间最常见的不良事件之一。我们在本文中回顾了老年患者行半紧急髋部骨折手术时抗血小板和抗血栓药物围手术期管理的现行建议和争议。