AB223. 196. The use of proton pump inhibitors in hip fracture patients

Background: Hip fractures represent a significant burden to every Orthopaedic department. Patients with hip fractures are at risk of gastrointestinal stress ulceration. In other specialities prophylactic proton pump inhibitors (PPIs) are used to reduce the associated morbidity. It is not common practice to prescribe prophylactic PPIs to patients who are admitted with hip fractures. This may lead to an increased morbidity associated with gastrointestinal stress ulceration in this patient population.

Methods: We conducted a retrospective study of data from six months of hip fractures admitted to our Orthopaedic unit. The rate of gastrointestinal stress ulceration and its complications were analysed in this patient cohort.

Results: Patients within the studied population who did not receive PPI medication had a higher rate of gastric stress ulcer complications. These included blood transfusion, additional interventions and resulted in delayed discharges. It was found that patients who were on PPI therapy prior to admission and subsequently kept on this during their admission were at a lower risk of complications.

Conclusions: Patients with hip fractures are at an increased risk of stress induced ulceration and the concomitant complications. Limited data suggests those taking PPI therapy had a lower risk. Orthopaedic surgeons should be aware of these risks in assessing their patients. We plan to implement the routine use of PPIs in those admitted to our department with hip fractures. This will allow us to further assess the benefit of this practice.

Keywords: Metal-on-metal; resurfacing; total hip arthroplasty; coral-chromium; revision arthroplasty; hip; fracture; ulceration; treatment