What steps can reduce morbidity and mortality caused by hip fractures?
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Surgery within 24 hours of hip fracture is a critical step in reducing complications, and may decrease mortality compared with conservative care (strength of recommendation [SOR]: B, cohort studies). Give patients heparin at the time of admission to prevent venous thromboembolism (VTE) (SOR: A, systematic reviews of RCTs). Anticoagulation should be continued in some form for 10 days or until the patient is fully ambulatory (SOR: A). Patients should also get prophylactic antibiotics in the 2 hours before surgery (SOR: A, meta-analysis of RCT).
Clinical Inquiries, 2007 (MU)
Journal of Family Practice, 56(11) 2007: 944-946.