Abstract: Objective To explore the effect of hemocoagulase combined with low-molecular-weight heparin (LMWH) on the prognosis and the survival time in the patients aged ≥90 years old with intertrochanteric femur fractures(ITFF) who received internal fixation operation. Methods From January 2016 to December 2019, a total of 67 patients aged ≥90 years old with ITFF who underwent proximal femoral nail antirotation (PFNA) operation were enrolled in this study. According to the perioperative anticoagulation therapy, they were divided into the combination group using hemocoagulase and LMWH (combination group, n=35) and LMWH group (n=32) using LMWH alone. The intraoperative blood loss, postoperative drainage volume, postoperative hidden blood loss, preoperative and postoperative hemoglobin (Hb) levels and survival time were compared between the two groups, and the factors affecting the long-term prognosis of the super-aged patients were analyzed. Results The hidden blood loss in LMWH group was 627.19±88.7 mL, compared with 521.71±92.75 mL in combination group (P<0.001). The Hb level in LMWH group was significantly lower than that in combination group 1 day and 3 days after operation (P<0.05). The cumulative survival rate within 30 months after operation in combination group was significantly higher than that in LMWH group (P=0.025). Cox proportional hazards model showed that LMWH therapy alone and high ASA classification significantly increased the risk of death in the super-aged patients with ITFF undergoing PFNA operation. Conclusions The combination of thrombin and LMWH can reduce postoperative hidden blood loss in super-aged patients with ITFF undergoing PFNA operation, and improve the prognosis of the patients.

Key words: intertrochanteric femur fracture, super-aged, prognosis, survival time