Evidence map›Paper›PMID 32889619›Full record

ArticleJournal of thrombosis and thrombolysis2021

Should patients treated with oral anti-coagulants be operated on within 48 h of hip fracture?

Michal Shani, Rina Yahalom, Doron Comaneshter, Keren Holtzman, Dorit Blickstein, Arnon Cohen, Alex Lustman

Abstract read
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In one paragraph

Article in Journal of thrombosis and thrombolysis, 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
0.8field-weighted citation impact, top 26% 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, 7 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. Review
  3. 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 · 2023
    Article
  4. Article
  5. Article
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

7 authors at 4 institutions in 1 country.

Michal ShaniDepartment of Family Medicine Central District, Clalit Health Service, Rehovot, Israel. michal.shani@gmail.com.ORCID http://orcid.org/0000-0002-1209-6201
Rina YahalomHospital Division, Clalit Health Services Headquarter, Tel Aviv, Israel.
Doron ComaneshterCommunity Division, Clalit Health Services Headquarter, Tel Aviv, Israel.
Keren HoltzmanWolfson Medical Center, Hulon, Israel.
Dorit BlicksteinThrombosis and Hemoatasis Unit, Institute of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
Arnon CohenCommunity Division, Clalit Health Services Headquarter, Tel Aviv, Israel.
Alex LustmanDepartment of Family Medicine Central District, Clalit Health Service, Rehovot, Israel.
Clalit Health Services · ILTel Aviv University · ILRambam Health Care Campus · ILWolfson Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To investigate if patients treated with oral anticoagulants (OAC) have delayed surgical intervention (more than 48 h) compared to patients without OAC therapy, and if there is an impact to surgery timing on hospitalization length and mortality. A retrospective cohort study of all patients aged over 65 registered with a new diagnosis of hip fracture who underwent surgery in one of the general hospitals run by Clalit, Israel between 01/01/2014 and 31/12/2017. Data was retrieved for patient demographics, OAC treatment, and Charlson comorbidity index. 5828 patients were operated for hip fractures, mean age was 82.8 years (65-108), 4013 (68.8%) were female. 415 were treated with direct oral anticoagulants (DOACs) (7.1%) and 311 with warfarin (5.3%) prior to their hospitalization. Patients taking OAC were less likely to be operated within 48 h from arrival to the hospital compared to patients not receiving OAC. The 30 day mortality was 4.2% among patients not receiving OAC, 6.0% among patients taking DOACs and 10.0% among patients receiving warfarin (p < 0.001). Adjusted odds ratio for mortality at 30 day among patients taking DOACs was similar to patients who didn't take OAC. (OR 1.0, CI 0.7, 1.6). The 30 day mortality rate of patients who were receiving OAC (either DOACs or warfarin) was not significantly different whether patients were operated within 48 h or not. Mortality rate was highest among patients taking warfarin. For patients who received DOACs, operation within 48 h wasn't associated with lower mortality rate. In these patients it seemed reasonable to adjust surgery time according to patients' characteristics and needs.

Indexed as

Hip FracturesWarfarinAdministration, OralAgedAged, 80 and overAnticoagulantsFemaleHumansRetrospective StudiesAnticoagulantsWarfarinDoacsElderlyHip fractureOral anticoagulantsWarfarin

Identifiers

PMID32889619
OpenAlexW3083689437

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.