Operative Delay for Orthopedic Patients on Clopidogrel (Plavix): A Complete Lack of Consensus

• DOI: 10.1097/ta.0b013e3180485d23
• Publication Date: 2008-04-04T07:03:31Z
• Authors: William F. Lavelle; Elizabeth A. Deme...; Richard Uhl
• Keywords: Adult; Male; Hip Fractures; Internship and Residency; Postoperative Hemorrhage; Prognosis; Risk Assessment; Perioperative Care; Clopidogrel; 3. Good health; Fracture Fixation, Internal; 03 medical and health sciences; Orthopedics; Postoperative Complications; 0302 clinical medicine; Health Care Surveys; Surveys and Questionnaires; Humans; Female; Practice Patterns, Physicians'; Emergency Treatment; Needs Assessment; Platelet Aggregation Inhibitors

: Because of its irreversible nature, Plavix (clopidogrel) has become a double edged sword in the care some our sickest patients, particularly when surgical intervention is required. Platelets exposed to single dose clopidogrel are affected for remainder their lifespan and recover normal platelet function at rate consistent with turnover, which within 5 days 7 (1-3) generation new platelets not influenced by drug; however, delay fixation orthopedic patients hip fractures may lead increased morbidity mortality.: A Web-based survey was created administered program directors academic surgery programs.: Seventy-three percent residency programs responded that waiting 3 or less urgent but nonemergent operative interventions on acceptable 23% feeling no all necessary. For emergent surgery, vast majority 66 (89%) reported operating room clopidogrel.: The who wait than do emergency cases clopidogrel. At this point we feel an early occurs approximately 2 days, acceptance possibility blood loss patient's best interest. Based reviewed physiology, perioperative transfusion be benefit as transfused would effective forming viable plug.