Treatment with vitamin K in hip fracture patients receiving warfarin

Abstract

Background: Hip fractures are common in the elderly population, but surgical treatment of these fractures within the first 48 hours decreases morbidity and mortality. The management of patients with hip fracture requiring surgery who are taking warfarin anticoagulation is unclear.

Objectives: To determine the effect of vitamin K on hip fracture patients treated with warfarin.

Methods: We retrospectively examined the management of 21 patients with hip fractures who were being treated with warfarin at the time of admission. Vitamin K was given to 11 of the 21 patients. A third group, which served as a control, consisting of 35 hip fracture patients who were not being treated with anticoagulants was also evaluated.

Results: Patients who received vitamin K took fewer days to reach target international normalized ratio (INR) (1.73 +/- 0.90 vs. 4.30 +/- 1.89, P < 0.001) and had less preoperative time (2.64 +/- 1.12 vs. 5.10 +/- 2.42 days, P < 0.008) when compared with patients who did not receive vitamin K. In addition, these patients had statistically significantly shorter hospitalization stays (9.4 +/- 1.9 and 13.2 +/- 4.9 days, one-sided P < 0.06). There was no difference in the amount of blood found in the wound drains (111.8 +/- 68.5 vs. 103.0 +/- 69.4 ml) or the number of blood units administered (1.45 +/- 1.29 vs. 2.00 +/- 2.75 units).

Conclusions: Treatment with vitamin K for hip fracture patients who receive warfarin shortens preoperative time, reduces the length of hospitalization and probably reduces morbidity and mortality.