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In the elderly patients with hip fracture, some often take antiplatelet drugs such as clopidogrel due to the ischemic cardiovascular or cerebrovascular diseases. In traditional practice, these patients often need to stop medication for 5-7 days before surgery. But on the other hand, delayed surgery will lead to a significant increase in fracture related complications. Therefore, the appropriate time for drug withdrawal is particularly important in this population.
Thromboelastography is a monitoring method that can accurately judge the anticoagulation status of patients. We hope to use thromboelastography to guide the time of drug withdrawal, shorten the time of drug withdrawal as much as possible, and reduce the incidence of fracture related complications without increasing the risk of massive hemorrhage.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TEG group | Experimental |
| |
| Non-TEG group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Thrombelastograph and surgical timing | Procedure | Patients in the TEG group will undergo a Thrombelastograph test after admission, and the timing of operation will be determined according to the results of the test, that is, 1 day, 3 days and 5 days later respectively for patients with ADP-induced platelet-fibrin clot strength (MAADP) of > 50 mm, 30-50 mm and < 30 mm. For Non-TEG patients, the drug withdrawal time is determined by the doctor in charge according to the clinical routine, generally about one week. |
| Measure | Description | Time Frame |
|---|---|---|
| Estimated red blood cell loss | The amount of red blood cell loss estimated by blood routine changes | From admission when the first blood routine will be obtained to discharge when the last blood routine will be obtained, up to postoperative day 7. |
| Measure | Description | Time Frame |
|---|---|---|
| Blood transfusion | Red blood cell infusion volume | From admission when the first blood routine will be obtained to discharge when the last blood routine will be obtained, up to postoperative day 7. |
| Measure | Description | Time Frame |
|---|---|---|
| Length of stay | Total length of stay | from admission to discharge,up to one year after operation |
| Mortality | One year all-cause mortality | within one year after operation |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Min Yan, Doctor | Contact | +86-13757118632 | zryanmin@zju.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Min Yan, Doctor | Zhejiang University | Study Director |
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| ID | Term |
|---|---|
| D006620 | Hip Fractures |
| ID | Term |
|---|---|
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D025981 | Hip Injuries |
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|
| Cerebrovascular accident | Ischemic brain disease | within one year after operation |
| Acute coronary syndrome | Ischemic heart disease | within one year after operation |
| D007869 |
| Leg Injuries |