Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patients

Background and purpose — Currently, no clear evidence exists on the pattern of use of antithrombotics at admission in hip fracture patients and how this has changed over time. We investigated temporal trends in—and factors associated with—the use of antithrombotics in patients admitted with a fractu...

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Main Authors: Christian Medom Madsen, Christopher Jantzen, Jes Bruun Lauritzen, Bo Abrahamsen, Henrik L Jorgensen
Format: Article
Language:English
Published: Taylor & Francis Group 2016-07-01
Series:Acta Orthopaedica
Online Access:http://dx.doi.org/10.1080/17453674.2016.1195662
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spelling doaj-88d52ec166a54e008150abbff9fd23802021-03-02T10:18:24ZengTaylor & Francis GroupActa Orthopaedica1745-36741745-36822016-07-0187436837310.1080/17453674.2016.11956621195662Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patientsChristian Medom Madsen0Christopher Jantzen1Jes Bruun Lauritzen2Bo Abrahamsen3Henrik L Jorgensen4Bispebjerg Hospital, University of CopenhagenBispebjerg Hospital, University of CopenhagenBispebjerg Hospital, University of CopenhagenHolbæk HospitalBispebjerg Hospital, University of CopenhagenBackground and purpose — Currently, no clear evidence exists on the pattern of use of antithrombotics at admission in hip fracture patients and how this has changed over time. We investigated temporal trends in—and factors associated with—the use of antithrombotics 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 specifically, 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 antithrombotics to ensure safe surgery and to avoid surgical delay.http://dx.doi.org/10.1080/17453674.2016.1195662
collection DOAJ
language English
format Article
sources DOAJ
author Christian Medom Madsen
Christopher Jantzen
Jes Bruun Lauritzen
Bo Abrahamsen
Henrik L Jorgensen
spellingShingle Christian Medom Madsen
Christopher Jantzen
Jes Bruun Lauritzen
Bo Abrahamsen
Henrik L Jorgensen
Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patients
Acta Orthopaedica
author_facet Christian Medom Madsen
Christopher Jantzen
Jes Bruun Lauritzen
Bo Abrahamsen
Henrik L Jorgensen
author_sort Christian Medom Madsen
title Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patients
title_short Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patients
title_full Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patients
title_fullStr Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patients
title_full_unstemmed Temporal trends in the use of antithrombotics at admission: A nationwide population-based cohort study of 154,047 hip fracture patients
title_sort temporal trends in the use of antithrombotics at admission: a nationwide population-based cohort study of 154,047 hip fracture patients
publisher Taylor & Francis Group
series Acta Orthopaedica
issn 1745-3674
1745-3682
publishDate 2016-07-01
description Background and purpose — Currently, no clear evidence exists on the pattern of use of antithrombotics at admission in hip fracture patients and how this has changed over time. We investigated temporal trends in—and factors associated with—the use of antithrombotics 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 specifically, 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 antithrombotics to ensure safe surgery and to avoid surgical delay.
url http://dx.doi.org/10.1080/17453674.2016.1195662
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