ArticleArchives of orthopaedic and trauma surgery2022
Early versus delayed surgery for hip fragility fractures in patients treated with direct oral anticoagulants.
Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Effects of pre-operative continuing oral anticoagulants or antiplatelets on health outcomes among older patients with hip fracture: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled it
- Early surgery of trochanteric femoral fractures in patients on direct oral anticoagulants (DOACs) reduces the length of stay (LOS) and the 1-year mortality rates without increasing the risk for revision surgery: a matched-pair analysis.Archives of orthopaedic and trauma surgery · 2026Article
- Review
- Early surgical fixation of proximal femur fractures under active direct oral anticoagulation (DOAC) therapy does not increase the postoperative blood loss. Results from a prospective cohort study with a matched-pair analysis.Archives of orthopaedic and trauma surgery · 2025Article
- Perioperative Management of Traditional and Direct Oral Anticoagulants in Hip Fracture Patients.Orthopedic reviews · 2024Article
- Is It Safe to Resume Direct Oral Anticoagulants upon Discharge after Hip Fracture Surgery? A Retrospective Study.Journal of clinical medicine · 2023Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelaying surgical treatment for hip fragility fractures increases mortality, but early intervention in patients treated with direct oral anticoagulant (DOAC) may increase the risk of perioperative blood loss due to residual drug activity. This study aimed to evaluate the effect of the timing of hip fragility fractures surgeries in patients treated with DOAC.
methodsWe retrospectively reviewed all records of DOAC-treated patients who underwent surgery for hip fragility fractures between 2011 and 2019. They were divided into three groups according to time to surgery since admission to the emergency room (ER), ≤ 24, 24-48, and ≥ 48 h. Blood loss, peri and postoperative complications, readmissions, and short- and long-term mortality were compared between groups.
resultsOf the 171 suitable patients (59 males and 112 females), 32 (18.7%) were in the ≤ 24 h group, 93 (54.4%) in the 24-48 h group, and 46 (26.9%) in the ≥ 48 h group. Timing of surgery did not affect blood loss, as indicated by changes in pre- and postoperative hemoglobin levels (p = 0.089) and proportion of perioperatively administered packed cells (p = 0.949). There was a trend towards increased 30-day mortality in the ≥ 48 h group compared to the 24-48 h and ≤ 24 h groups (13.0, 4.3 and 3.1%, respectively. p = 0.099), and a trend towards increased 90 day mortality (6.5, 3.2, and 0%, respectively. p = 0.298).
conclusionsEarly surgery did not increase perioperative blood loss. Delayed surgery ≥ 48 h of patients receiving DOAC who underwent surgery for hip fragility fractures showed a trend towards increased 30 day and 90 day mortality.
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