ArticleScandinavian journal of trauma, resuscitation and emergency medicine2021
Falls in ED patients: do elderly patients on direct oral anticoagulants bleed less than those on vitamin K antagonists?
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 9 citations in OpenAlex.
- Mortality and morbidity predictors in older persons with mild traumatic brain injury: A district-wide study.Neurosurgical review · 2026Article
- Just the facts: head injury following ground-level falls in older patients-to scan or not to scan?CJEM · 2024Article
- Epidemiology of maxillofacial trauma in elderly patients receiving oral anticoagulant or antithrombotic medication; a Swiss retrospective study.BMC emergency medicine · 2024Article
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Authors and funding
5 authors at 2 institutions in 1 country.
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Abstract
backgroundFalls from standing are common in the elderly and are associated with a significant risk of bleeding. We have compared the proportional incidence of bleeding complications in patients on either direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA).
methodsOur retrospective cohort study compared elderly patients (≥65 years) on DOAC or VKA oral anticoagulation who presented at the study site - a Swiss university emergency department (ED) - between 01.06.2012 and 01.07.2017 after a fall. The outcomes were the proportional incidence of any bleeding complication and its components (e.g. intracranial haemorrhage), as well as procedural and clinical parameters (length of hospital stay, admission to intensive care unit, in-hospital-mortality). Uni- and multivariable analyses were used to compare the studied outcomes.
resultsIn total, 1447 anticoagulated patients were included - on either VKA (n = 1021) or DOAC (n = 426). There were relatively more bleeding complications in the VKA group (n = 237, 23.2%) than in the DOAC group (n = 69, 16.2%, p = 0.003). The difference persisted in multivariable analysis with 0.7-fold (95% CI: 0.5-0.9, p = 0.014) lower odds for patients under DOAC than under VKA for presenting with any bleeding complications, and 0.6-fold (95% 0.4-0.9, p = 0.013) lower odds for presenting with intracranial haemorrhage. There were no significant differences in the other studied outcomes.
conclusionsAmong elderly, anticoagulated patients who had fallen from standing, those under DOACs had a lower proportional incidence of bleeding complications in general and an even lower incidence of intracranial haemorrhage than in patients under VKAs.
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