ArticleEuropean geriatric medicine2020
Do direct oral anticoagulants (DOACs) cause delayed surgery, longer length of hospital stay, and poorer outcome for hip fracture patients?
Article in European geriatric medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 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
- Preoperative antithrombotic use is associated with delayed mobilization and plural blood transfusions following hip fracture surgery: a case-control study.European geriatric medicine · 2026Article
- Management and optimisation in the preoperative phase for patients with a fractured hip.EFORT open reviews · 2026Review
- Perioperative Anemia and Transfusion Management in Older Adults with Osteoporotic Hip Fractures: A Narrative Review of Current Evidence and Emerging Strategies.Clinical interventions in aging · 2026Review
- 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
- In the shadow of stability lies ruin: Occult vascular injuries in geriatric pelvic trauma.World journal of clinical cases · 2025Article
- Impact of three sequential orthogeriatric care models on time to surgery after hip fracture: a retrospective study.BMC geriatrics · 2025Observational
- 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
- Proximal Femur Fractures: Evaluating the Necessity of On-Call Surgery.Journal of clinical medicine · 2024Article
- Early Hip Fracture Surgery in Patients Taking Direct Oral Anticoagulants Improves Outcome.Journal of clinical medicine · 2024Article
- Use of direct-acting anticoagulants (DOACs) delays surgery and is associated with increased mortality in hip fracture patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 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
- 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
- Role of DOAC plasma concentration on perioperative blood loss and transfusion requirements in patients with hip fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Timing and safety of hip fracture surgery in patients on direct-acting oral anticoagulants.Journal of clinical orthopaedics and trauma · 2023Article
- Proximal femur fractures in patients taking anti-coagulants: has anything changed?EFORT open reviews · 2022Review
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe perioperative consequences of direct oral anticoagulants (DOACs) in hip fracture patients are not sufficiently investigated. The primary aim of this study was to determine whether DOAC-users have delayed surgery compared to non-users. Secondarily, we studied whether length of hospital stay, mortality, reoperations and bleeding complications were influenced by the use of DOAC.
methodsThe medical records of 314 patients operated for a hip fracture between 2016 and 2017 in a single trauma center were assessed. Patients aged < 60 and patients using other forms of anticoagulation than DOACs were excluded. Patients were followed from admission to 6 months postoperatively. Surgical delay was defined as time from admission to surgery. Secondary outcomes included length of hospital stay, transfusion rates, perioperative bleeding loss, postoperative wound ooze, mortality and risk of reoperation. The use of general versus neuraxial anaesthesia was registered. Continuous outcomes were analysed using Students t test, while categorical outcomes were expressed by Odds ratios.
results47 hip fracture patients (15%) were using DOACs. No difference in surgical delay (29 vs 26 h, p = 0.26) or length of hospital stay (6.6 vs 6.1 days, p = 0.34) were found between DOAC-users and non-users. DOAC-users operated with neuraxial anaesthesia had longer surgical delay compared to DOAC-users operated with general anaesthesia (35 h vs 22 h, p < 0.001). Perioperative blood loss, transfusion rate, risk of bleeding complications and mortality were similar between groups.
conclusionHip fracture patients using DOAC did not have increased surgical delay, length of stay or risk of reported bleeding complications than patients without anticoagulation prior to surgery. The increased surgical delay found for DOAC-users operated with neuraxial anaesthesia should be interpreted with caution.
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