{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:42:13Z","timestamp":1790883733367,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The purpose of this study was first, to assess the relationship between preoperative INR (international normalised ratio) and postoperative complication rates in patients with a hip fracture, and second, to establish a threshold for INR below which the risk of complications is comparable to those in patients with a normal INR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program and found 35,910 cases who had undergone surgery for a hip fracture between 2012 and 2018. Cases were stratified into 4 groups based on their preoperative INR levels: &lt;1.4; \u2a7e1.4 and &lt;1.6; \u2a7e1.6 and &lt;1.8 and \u2a7e1.8. These cohorts were assessed for differences in preoperative factors, intraoperative factors, and postoperative course. Multivariate logistic regression was used to assess the risk of transfusion, 30-day mortality, cardiac complications, and wound complications adjusting for all preoperative and intraoperative factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 35,910 cases, 33,484 (93.2%) had a preoperative INR\u2009&lt;\u20091.4; 867 (2.4%) an INR \u2a7e1.4 and &lt;1.6; 865 (2.4%) an INR\u2009\u2a7e\u20091.6 and &lt;1.8 and 692 (1.9%) an INR\u2009\u2a7e\u20091.8. A preoperative INR\u2009\u2a7e\u20091.8 was independently associated with an increased risk of bleeding requiring transfusion. A preoperative INR\u2009\u2a7e\u20091.6 was associated with an increased risk of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We found that an INR of &lt;1.6 is a safe value for patients who are to undergo surgery for a hip fracture. Below this value, patients avoid an increased risk of both transfusion and 30-day mortality seen with higher INR values. These findings may allow adjustment of preoperative protocols and improve the outcome of hip fracture surgery in this group of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000221148096","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T23:37:29Z","timestamp":1673998649000},"page":"941-947","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Determining a preoperative international normalised ratio threshold safe for hip fracture surgery"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9568-7663","authenticated-orcid":false,"given":"Kevin L","family":"Mekkawy","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3721-1317","authenticated-orcid":false,"given":"Yash P","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G","family":"Mawn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife","family":"MacMahon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-2353","authenticated-orcid":false,"given":"Julius 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