{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:09:11Z","timestamp":1790647751843,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>To evaluate the effect of warfarin on blood transfusion and postoperative complications in a low-energy hip fracture population compared with a non-anticoagulated comparison group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Multicenter Retrospective Cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Three Urban Level I Academic Trauma Centers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Acute, low-energy, native hip fractures in patients 55 years of age or older on chronic warfarin anticoagulation, propensity score matched 1:2 to non-anticoagulated hip fracture patients meeting all other inclusion criteria.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Transfusion and postoperative complication rates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Two hundred ten anticoagulated hip fracture patients were matched to 420 nonanticoagulated patients. A higher proportion of patients required blood transfusion in the warfarin cohort (52.4% vs. 43.3%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), attributable mostly to the subgroup of patients undergoing arthroplasty. Warfarin patients had higher incidence of overall 90-day complications (47% vs. 38%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.039) and readmissions (31.4% vs. 8.9%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Day of surgery international normalized ratio (INR) did not influence transfusions or complications among warfarin patients. Warfarin patients undergoing surgery within 24 hours had no difference in transfusions and had fewer complications compared with those undergoing surgery after 24 hours. On multivariable logistic regression analysis, warfarin use and day of surgery INR were not predictors of transfusion or complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Patients on warfarin experienced longer time to surgery and higher incidence of overall transfusion and postoperative complications within 90 days of surgery. However, warfarin use and day of surgery INR was not independently associated with transfusions or complications. The reason for poorer outcomes in warfarin patients remains a topic of further investigation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002484","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T18:03:08Z","timestamp":1662055388000},"page":"57-63","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Chronic Warfarin Anticoagulation in Hip Fracture Patients Delays Surgery and Is Associated With Increased Risk of Postoperative Complications: A Multicenter Propensity-Score\u2013Matched Analysis"],"prefix":"10.1097","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9506-6322","authenticated-orcid":false,"given":"Ashley E.","family":"Levack","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, Maywood, IL;"},{"name":"Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold G.","family":"Moore","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen R.","family":"Stephan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cedars-Sinai Health System, Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian G.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cedars-Sinai Health System, Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Garlich","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cedars-Sinai Health System, Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan","family":"Hadad","sequence":"additional","affiliation":[{"name":"Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton T. 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