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This study examined the hypothesis that patients on warfarin before sustaining orthopedic injuries will have increased morbidity and mortality compared with matched control patients not on warfarin.Records of consecutive trauma patients on warfarin with orthopedic fractures who presented from January 1997 to June 2002 to a Level I trauma center were retrospectively analyzed. Data were evaluated using the χ2 and Student's t tests and nonparametric tests when appropriate; values of p < 0.05 were considered significant.A study group of 53 patients was available for review. In comparison with the control group, significant differences were found in time delay from admission to surgery (p = 0.005), hospital length of stay (p = 0.03), total units of blood transfused (p = 0.03), and discharge disposition (p < 0.0003). No difference was found in number of intensive care unit days, complications, or mortality.Preinjury warfarin impacts outcomes of geriatric trauma patients sustaining orthopedic injuries.