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In general, surgery should be done promptly after hip fracture. However, when the patient has been taking clopidogrel (Plavix), the surgeon might be concerned about excessive perioperative bleeding. In fact, the following statement appears in the official prescribing information for clopidogrel: “If a patient is to undergo surgery and an antiplatelet effect is not desired, discontinue Plavix five days prior to surgery.”
In this retrospective cohort study from Mayo Clinic, investigators identified 40 hip-fracture patients who were taking clopidogrel at admission and who underwent surgery within 36 hours. Cases were compared with 80 controls (matched for age, sex, and several other clinical variables) who also underwent prompt surgery for hip …