Is warfarin usage a risk factor for osteoporotic fractures? A cohort study in the emergency department

Background Several studies have examined the association between warfarin sodium use and risk of osteoporotic fractures with conflicting results. Our study addresses this question, for the first time regarding patients attending emergency department (ED). Aims The aim of this study was to retrospectively detect whether there is higher rate of usage of warfarin sodium in patients with osteoporotic fractures attending an ED. Methods This is a retrospective study from patients’ computerized charts. All individuals >65 years old who had an osteoporotic fracture and attended an ED in a tertiary hospital were compared with a similar group of elderly individuals >65 years old without an osteoporotic fracture who attended the ED for a cause other than an osteoporotic fracture. Results This study included 328 patients who were evaluated in the years 2005-2016. Overall, 164 individuals with a typical osteoporotic fracture (hip -66 patients (40 per cent), spine- 92 patients (56 per cent), humerus -4 patients (2 per cent), radius -13 patients (8 per cent)) were identified and compared with a matched group of elderly individuals who were evaluated in the ED for other complaints. Warfarin sodium was used in 61 individuals (19 per cent) in the entire cohort, 34 in the fracture group and 27 in the non-fracture group (p=0.324). Conclusion In elderly patients, attending an ED, warfarin sodium use does not seem to be a risk factor for an osteoporotic fracture.