Manejo perioperatorio del paciente con fractura de cadera y tratamiento con fármacos anticoagulantes o antiagregantes. Recomendaciones de consenso de la sección de hemostasia de la SEDAR

IF 0.9 Q3 ANESTHESIOLOGY Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-01-01 DOI:10.1016/j.redar.2024.501651

C. Cassinello , R. Ferrandis , A. Gómez-Luque , F. Hidalgo , J.V. Llau , G. Yanes-Vidal , P. Sierra

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Abstract

Background

Antiaggregant and anticoagulant therapy complicate the management of patients with osteoporotic hip fracture.

Methods

The haemostasis section of SEDAR established a working group to define an action plan for the management of antiaggregated or anticoagulated patients with an osteoporotic hip fracture. The suggested recommendations are based on evidence of best practices, and have been validated by a multidisciplinary group formed by 6 specialties.

Results

Early surgery reduces complications and mortality and improves patient comfort and functional recovery, with no difference in mortality between intradural and general anaesthesia.

Conclusions

Although uncertainties remain, it is recommended to perform surgery within 24-48 hours of admission, adapting peripheral nerve blocks and type of anesthesia (neuraxial or general) an to the haemostatic conditions. A multimodal management of antithrombotics, and the optimisation of haemostasis, haemoglobin and venous thromboprophylaxis since admission are suggested.

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