Relationships between hemostatic variables and delay of surgical repair of femoral neck fracture in elderly patients
Masuda, Y.; Kita, A.; Ohta, K.; Namiki, A.
Masui. Japanese Journal of Anesthesiology 53(5): 522-527
2004
ISSN/ISBN: 0021-4892 PMID: 15198235 Document Number: 580339
Background : This study was conducted to clarify the preoperative risk of thrombosis in elderly patients with femoral neck fracture by determining the relationships between hemostatic variables and time from injury until surgical repair. Methods: Thirty-four patients over 70 years of age with femoral neck fracture were assigned to the following three groups according to the delay of surgical repair: usual operation group (within 3 days), delayed operation group (from 4 to 7 days) and much delayed operation group (more than 8 days). Hemostatic variables including molecular markers were determined before surgical repair. Results : Thrombin-antithrombin complex level in the usual operation group was significantly increased. The D-dimer level in the usual operation group was significantly higher than that in the delayed operation group, but the levels in the delayed and much delayed operation groups were still higher than the levels in normal subjects. Conclusions : These findings suggest that elderly patients with femoral neck fracture may have a relatively high risk for the occurrence of pulmonary thromboembolism receiving anesthesia for surgical repair because of hypercoagulopathy caused by stress response and possible deep vein thrombosis caused by lying on a bed for a long period.