I read with interest this paper that addresses a common orthopaedic dilemma regarding timing of hip fracture surgery in patients on antiplatelet therapy. Clarification of a few points may help myself and other readers.
First, data for type of operation were recorded but not presented. Many would argue that there is significant variation in blood loss among operation types.
Second, the data between Tables 1 and 2 appear incongruous. I would expect the totals for complications and units of blood transfused to be the same in both tables as they are the same patient cohort.
Third, the method of blood loss estimation using pre/post-operative haemoglobin levels has been identified correctly as a limitation of the study. When comparing early versus late surgery, a statistically significant difference in blood loss is described but, given that Table 1 shows the same transfusion rate between groups, is this difference clinically significant?
Last, patients on clopidogrel and dipyridamole only were described. Out of a total of 619 neck of femur fractures, one would expect a large number to be on long-term aspirin. Comparison between matched groups of aspirin and other antiplatelet drugs would have been interesting but most informative of all would be the impact of dual antiplatelet therapy.