ArticleJournal of clinical orthopaedics and trauma2020
Is anticoagulation reversal necessary prior to surgical treatment of geriatric hip fractures?
Article in Journal of clinical orthopaedics and trauma, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Safety of expedited-surgery protocols in anticoagulant-treated patients with hip fracture: a systematic review and meta-analysis.Canadian journal of surgery. Journal canadien de chirurgiePooled it
- The Preoperative Waiting Time on Long-Term Survival Following Elderly Hip Fracture Surgery.Geriatrics (Basel, Switzerland) · 2025Article
- Preoperative anticoagulation and its impact on surgical timing and postoperative outcomes in hip fracture surgery: a retrospective study at an Orthogeriatrics Clinical Care Center in Colombia.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 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
- Advancements in the Optimization of Surgical Timing in Elderly Patients with Hip Fractures: A Narrative Review and Future Perspectives.Clinical interventions in aging · 2025Review
- The management of anticoagulated fragility femoral fracture patients.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2024Review
- Perioperative Management of Traditional and Direct Oral Anticoagulants in Hip Fracture Patients.Orthopedic reviews · 2024Article
- Propensity matched analysis examining the effect of passive reversal of direct oral anticoagulants on blood loss and the need for transfusions among traumatic geriatric hip fractures.European journal of medical research · 2023Article
- Review of perioperative outcomes and management of hip fracture patients on direct oral anticoagulants.EFORT open reviews · 2023Review
- The Effect of Pre-operative use of Antiplatelets and Anticoagulants on Time to Surgery in Hip Fracture Patients.Malaysian orthopaedic journal · 2023Article
- Early versus delayed surgery for hip fragility fractures in patients treated with direct oral anticoagulants.Archives of orthopaedic and trauma surgery · 2022Article
- Orthogeriatric co-management for the care of older subjects with hip fracture: recommendations from an Italian intersociety consensus.Aging clinical and experimental research · 2021Review
- Partial warfarin reversal prior to hip fracture surgical intervention in geriatric trauma patients effects on blood loss and transfusions.Journal of clinical orthopaedics and trauma · 2021Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHip fracture surgery in geriatric patients on anticoagulants may increase the risk for blood loss. Anticoagulation reversal may lower these risks; however, data on blood loss and transfusions are limited. The study purpose was to compare outcomes between hip fracture patients 1) not on anticoagulants 2) whose anticoagulants were reversed, and 3) whose anticoagulants were not reversed.
methodsThis four-year retrospective cohort study at six Level 1 Trauma Centers enrolled geriatric patients (≥65) with isolated hip fractures. The primary outcome was total hospital blood loss (ml). Secondary outcomes: hospital length of stay (HLOS) and volume of packed red blood cells (pRBC) transfusions (ml). Statistical analyses included: Fisher's, chi-squared, Kruskal-Wallis, linear mixed-effect and logistic regression. Bonferroni adjusted alpha = 0.025.
resultsOf the 459 patients, 189 (41%) were not on anticoagulants, 186 (41%) were reversed, and 84 (18%) were not reversed. The LS mean (SE) blood loss was 134 ml (12) for not reversed patients and 159 (17) for reversed patients; no significant difference compared to those not on anticoagulants [138 (12)], p-diff = 0.14 and 0.83, respectively. The LS mean (SE) HLOS was significantly longer for the reversed patients, 7.7 (0.4) days, when compared to those not on anticoagulants, 6.8 (0.4), p = 0.02, and when compared to those not reversed, 6.3 (0.6), p = 0.01. There was no significant difference in pRBC transfusions.
conclusionNot reversing anticoagulants for geriatric hip fractures was not associated with increased volume of blood loss or transfusions when compared to those reversed. Delayed surgery for anticoagulant reversal may be unnecessary and contributing to an increased HLOS.
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