d781acbad1fdfd3419fceb2283a5bcad 303912.pdf 31232de0f5370d5a4cf7d3aab4b3b5fa439f353c 303912.pdf 645ff2a70a33f45f1c854477e6ae4fac1116fb78c956cf6744d388cd17fc4e56 303912.pdf Title: Quality of Life and Post-Surgical Complications in Patients on Chronic Antiplatelet Therapy with Proximal Femur Fracture: 12-Month Follow-Up after Implementing a Strategy to Shorten the Time to Surgery Subject: Background: We evaluated a strategy to shorten the time from admission to surgery in patients with proximal femur fractures on chronic antiplatelet therapy. We reported a 12-month follow-up on complications and quality of life (QoL). Methods: Multicentre, open-label, randomized, parallel clinical trial. Patients were randomized to either early platelet function-guided surgery (experimental group) or delayed surgery (control group). Medical and surgical complications and QoL (EQ-5D-5L questionnaire) were assessed during the hospital stay, and after hospital discharge at 30 days, and 6 and 12 months. Results: From 156 randomized patients, 143 patients underwent surgery. The mean age was 85.5 (7.8) years and 68.0% were female. After hospital discharge, 5.7% of patients had surgical wound complications and 55.9% had medical complications, with 42.7% having serious adverse events. QoL improved significantly after surgery, with the best scores at the six-month follow-up. The overall mortality was 32.2%. There were no differences between early and delayed surgery groups in any assessed outcomes. Conclusion: It seems safe to reduce the time of surgery under neuraxial anaesthesia in patients with hip fractures on chronic antiplatelet therapy by platelet function testing. QoL in particular improves in the first six months after surgery. Keywords: femur fracture; antiplatelet drugs; randomized clinical trial Author: Angela Merchán-Galvis, Rafael Anaya, Mireia Rodriguez, Jordi Llorca, Mercé Castejón, José María Gil, Angélica Millan, Verónica Estepa, Elena Cardona, Yaiza Garcia-Sanchez, Ana Ruiz, Maria Jose Martinez-Zapata and AFFEcT Study Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Feb 8 12:10:25 2023 CET ModDate: Wed Feb 8 12:12:44 2023 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1497671 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 ACKGZT+VnURWPalladioL Type 1 Custom yes yes no 15 0 EUHREV+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 CNWTQX+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 XTUACS+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 FKUIVJ+CMSY10 Type 1 Builtin yes yes no 71 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 81 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 93 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 97 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 101 0 BCDJEE+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 105 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 118 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 122 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 126 0 BCDIEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 130 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 146 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 150 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 154 0 BCDIEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 158 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 170 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 174 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 178 0 GEJNTL+VnURWPalladioL-Italic Type 1 Custom yes yes no 193 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-12-19 02:52:30 CET RepresentationInformation: 303912.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-12-18 13:49:31 CET Size: 1497671 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 359 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Interventions Destination: subsection.2.1 Item: Title: Outcomes Destination: subsection.2.2 Item: Title: Ethics Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Quality of Life and Post-Surgical Complications in Patients on Chronic Antiplatelet Therapy with Proximal Femur Fracture: 12-Month Follow-Up after Implementing a Strategy to Shorten the Time to Surgery Author: Angela Merchán-Galvis, Rafael Anaya, Mireia Rodriguez, Jordi Llorca, Mercé Castejón, José María Gil, Angélica Millan, Verónica Estepa, Elena Cardona, Yaiza Garcia-Sanchez, Ana Ruiz, Maria Jose Martinez-Zapata and AFFEcT Study Group Subject: Background: We evaluated a strategy to shorten the time from admission to surgery in patients with proximal femur fractures on chronic antiplatelet therapy. We reported a 12-month follow-up on complications and quality of life (QoL). Methods: Multicentre, open-label, randomized, parallel clinical trial. Patients were randomized to either early platelet function-guided surgery (experimental group) or delayed surgery (control group). Medical and surgical complications and QoL (EQ-5D-5L questionnaire) were assessed during the hospital stay, and after hospital discharge at 30 days, and 6 and 12 months. Results: From 156 randomized patients, 143 patients underwent surgery. The mean age was 85.5 (7.8) years and 68.0% were female. After hospital discharge, 5.7% of patients had surgical wound complications and 55.9% had medical complications, with 42.7% having serious adverse events. QoL improved significantly after surgery, with the best scores at the six-month follow-up. The overall mortality was 32.2%. There were no differences between early and delayed surgery groups in any assessed outcomes. Conclusion: It seems safe to reduce the time of surgery under neuraxial anaesthesia in patients with hip fractures on chronic antiplatelet therapy by platelet function testing. QoL in particular improves in the first six months after surgery. 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