Evidence map›Paper›PMID 32710342›Full record

ArticleArchives of orthopaedic and trauma surgery2021

Outcome of older hip fracture patients on anticoagulation: a comparison of vitamin K-antagonists and Factor Xa inhibitors.

M Gosch, M Jacobs, H Bail, S Grueninger, S Wicklein

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. 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 · 2022
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

M GoschDepartment for Geriatric Medicine, Paracelsus Private Medical University, General Hospital Nuremberg, Prof. Ernst Nathan Strasse 1, 90419, Nuremberg, Germany. markus.gosch@pmu.ac.at.ORCID http://orcid.org/0000-0001-7720-2506
M JacobsDepartment for Geriatric Medicine, Paracelsus Private Medical University, General Hospital Nuremberg, Prof. Ernst Nathan Strasse 1, 90419, Nuremberg, Germany.
H BailDepartment for Orthopaedics and Traumatology, Paracelsus Private Medical University, General Hospital Nuremberg, Nuremberg, Germany.
S GrueningerDepartment for Orthopaedics and Traumatology, Paracelsus Private Medical University, General Hospital Nuremberg, Nuremberg, Germany.
S WickleinDepartment for Geriatric Medicine, Paracelsus Private Medical University, General Hospital Nuremberg, Prof. Ernst Nathan Strasse 1, 90419, Nuremberg, Germany.
Nuremberg Hospital · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOlder hip fracture patients are still challenging in daily clinical practice. Due to the high prevalence of osteoporosis and atrial fibrillation in this age group, the number of fragility fracture patients under oral anticoagulation (OAC) increases. The outcome is still disappointing, short- and long-term mortality and morbidity is high. The impact of pre-existing OAC is not yet clear, especially regarding new OAC drugs like Factor Xa inhibitors (FXa). The purpose of our study was to compare the short-term outcome of older hip fracture patients, without OAC (controls), on Vitamin K antagonists (VKA) and on FXa. MATERIALS AND

methodsThe study is a retrospective case-control study including patients older than 70 years who sustained hip fractures caused by an inadequate trauma and treated at a level 1 trauma center from February 2017 to June 2018. Patient's information was taken from patient's charts. 102 cases were analysed, 61 controls, 41 on OAC (15 on VKA and 26 on FXa). As outcome parameter we defined mortality, perioperative complications, bleeding, need of blood supplements, delay of surgery, length of stay, and a combined outcome parameter (mortality, myocardial infarction, stroke, thromboembolic events, blood preservations, re-vision surgery, major bleeding and decline of hemoglobin).

resultsEight patients died during hospital stay, in-hospital mortality was 7.8%. The highest mortality rate was found in patients on VKA (20%), compared to patients on FXa (3.8%) and controls (6.6%). However, mortality rate did not differ significantly within the groups. The combined endpoint was significantly more frequently seen in patients on OAC compared to controls (p = 0.006). No difference was observed between patients on VKA or FXa. Mean time to surgery and LOS was significantly longer in patients on OAC compared to controls. No significant differences were seen between VKA and FXa.

conclusionsIn our study OAC was significantly associated with worse outcome compared to controls. Marginal differences were observed between patients on FXa or VKA. Further studies involving a higher number of patients are necessary to confirm our results. At that time, some our results have to interpreted carefully and need confirmation.

Indexed as

Hip FracturesAnticoagulantsAtrial FibrillationCase-Control StudiesFactor Xa InhibitorsHumansRetrospective StudiesTreatment OutcomeVitamin KAnticoagulantsFactor Xa InhibitorsVitamin KDOACFactor Xa inhibitorsFragility fracturesHip fractureOral anticoagulation

Identifiers

PMID32710342
OpenAlexW3045211365

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.