Use of calcium antagonists and need for perioperative transfusion in older patients with hip fracture: observational study

Abstract

Calcium antagonists inhibit platelet aggregation,1 which may increase the risk of bleeding.2 Whether these drugs increase postsurgical haemorrhage remains controversial,3 but more attention is being given to reducing surgical bleeding because of the risks associated with homologous transfusions.4 We evaluated the haemorrhagic potential of calcium antagonists in hip surgery, which is associated with considerable transfusion requirements. We prospectively evaluated the need for perioperative transfusion in 161 consecutive elderly patients with hip fracture (mean (SE) age 80 (0.5) years; 82% women) who had cemented total hip arthroplasty (85 subjects), hemiarthroplasty (16), or osteosynthesis (60) in 1994-5. One hundred patients had hypertension, 19 diabetes, 47 vascular disease, six liver disease, and 17 peptic disease. Nitrates were taken by 56 patients, angiotensin converting enzyme inhibitors by 44, digitalis by 39, diuretics …