ArticleGeriatric orthopaedic surgery & rehabilitation2018
Use of Anticoagulants Remains a Significant Threat to Timely Hip Fracture Surgery.
Article in Geriatric orthopaedic surgery & rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Synthesis of the evidence on the impact of pre-operative direct oral anticoagulants on patient health outcomes after hip fracture surgery: rapid systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- Clinical outcomes in elderly patients on direct oral anticoagulant drugs undergoing surgery for acute hip fracture (AHF).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Impact of anticoagulation therapy on surgical timing, hospital stay, and postoperative outcomes in proximal femur fracture patients.Acta orthopaedica et traumatologica turcica · 2025Article
- Management of hip fracture patients on direct oral anticoagulants: a survey of orthopaedic trauma surgeons, systematic review, and meta-analysis.OTA international : the open access journal of orthopaedic trauma · 2025Article
- DOACs levels in patients with hip fracture: is there a relation with renal function and time from last drug intake?Internal and emergency medicine · 2024Article
- Pre-Operative Direct Oral Anticoagulant Level Measurement Reduces Time to Surgery in Hip Fracture Patients.Geriatric orthopaedic surgery & rehabilitation · 2024Article
- Preoperative Drug Monitoring in Management of Patients with Hip Fracture on Treatment with Direct Oral Anticoagulants.Clinical interventions in aging · 2024Article
- Expedited surgery does not increase transfusion rates for patients with geriatric hip fracture taking factor Xa inhibitors.OTA international : the open access journal of orthopaedic trauma · 2023Article
- Review of perioperative outcomes and management of hip fracture patients on direct oral anticoagulants.EFORT open reviews · 2023Review
- The Effect of Warfarin Use on Postoperative Outcomes after Femoral Neck Surgery.Journal of clinical medicine · 2023Article
- Assessing operative delay and complications in hip fracture patients on anticoagulants and antiplatelets.SAGE open medicine · 2023Article
- Article
- Timing of Surgery for Hip Fracture in Patients on Direct Oral Anti-coagulants: A Population-Based Cohort Study.Geriatric orthopaedic surgery & rehabilitation · 2022Article
- [Risk factors affecting mortality in patients with hip fractures at a regional trauma center].Zeitschrift fur Gerontologie und Geriatrie · 2021Article
- Blood transfusions and hip fracture mortality - A retrospective cohort study.Journal of clinical orthopaedics and trauma · 2021Article
- Management of ongoing direct anticoagulant treatment in patients with hip fracture.Scientific reports · 2021Observational
- Early Surgical Fixation for Hip Fractures in Patients Taking Direct Oral Anticoagulation: A Retrospective Cohort Study.Geriatric orthopaedic surgery & rehabilitation · 2020Article
- Perioperative Considerations in the Management of Anticoagulation Therapy for Patients Undergoing Surgery.Current pain and headache reports · 2019Review
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHip fracture remains the biggest single source of morbidity and mortality in the elderly trauma population, and any intervention focused on quality improvement and system efficiency is beneficial for both patients and clinicians. Two of the variables contributory to improving care and efficiency are time to theater and length of stay, with the overall goal being to improve care as reflected within the achievement of best practice tariff. One of the biggest barriers to optimizing these variables is preinjury anticoagulation.
methodBuilding on our previous work with warfarin in this population, we utilized a regional hip fracture collaborative network collecting prospective data through the National Hip Fracture Database with custom fields pertaining to all agents, including novel oral anticoagulants.
resultsIn all, 1965 hip fracture patients median age 83 years (1639 not anticoagulated) were admitted to the 5 centers over 12 months. Median length of stay was 20.71 days; time to theater 23.09 hours, and the populations (anticoagulated vs control) were evenly matched for injury. Anticoagulated patients were delayed to theater (
conclusionsDespite the widespread use of newer anticoagulants, popular due to unmonitored reversal and administration, patients stay longer in hospital and wait longer for surgery than nonanticoagulated patients of the same age and injury. Contemporary perioperative practices impact negatively on the ability to perform timely surgery on hip fracture patients. We propose a guideline specific to the management of anticoagulation in the hip fracture population to aid the optimum preparation of patients for theater, achievement of timely surgery, and potentially reduce length of stay.
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