ArticleCanadian journal of surgery. Journal canadien de chirurgie2021
Management of patients with hip fracture receiving anticoagulation: What are we doing in Canada?
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Effectiveness of Four-Factor Prothrombin Complex Concentrate Versus Plasma in Patients on Vitamin K Antagonists Undergoing Urgent Orthopedic Surgery: A Post Hoc Analysis.Advances in therapy · 2026Trial
- Blood Transfusion Risk Following Early Versus Delayed Surgery in Hip Fracture Patients on Direct Oral Anticoagulants: A Study Protocol for a Natural Experiment.Journal of clinical medicine · 2026Article
- Impact of anticoagulation therapy on surgical timing, hospital stay, and postoperative outcomes in proximal femur fracture patients.Acta orthopaedica et traumatologica turcica · 2025Article
- The management of anticoagulated fragility femoral fracture patients.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2024Review
- Management and 1-Year Outcome in Elderly Patients with Hip Fracture Surgery Receiving Anticoagulation (Warfarin or DOAc) or P2Y12 Antiplatelet Agents.Journal of clinical medicine · 2023Article
- Review of perioperative outcomes and management of hip fracture patients on direct oral anticoagulants.EFORT open reviews · 2023Review
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDirect oral anticoagulants (DOACs) are rapidly replacing warfarin for therapeutic anticoagulation; however, many DOACs are irreversible and may complicate bleeding in emergent situations such as hip fracture. In this setting, there is a lack of clear guidelines for the timing of surgery. The purpose of this study was to evaluate the current practices of Canadian orthopedic surgeons who manage patients with hip fracture receiving anticoagulation.
methodsIn January-March 2018, we administered a purpose-specific cross-sectional survey to all currently practising orthopedic surgeons in Canada who had performed hip fracture surgery in 2017. The survey evaluated approaches to decision-making and timing of surgery in patients with hip fracture receiving anticoagulation.
resultsA total of 280 surgeons representing a mix of academic and community practice, seniority and fellowship training responded. Nearly one-quarter of respondents (66 [23.4%]) were members of the Canadian Orthopaedic Trauma Society (COTS). Almost three-quarters (206 [73.6%]) felt that adequate clinical guidelines for patients with hip fracture receiving anticoagulation did not exist, and 177 (61.9%) indicated that anesthesiology or internal medicine had a greater influence on the timing of surgery than the attending surgeon. A total of 117/273 respondents (42.9%) indicated that patients taking warfarin should have immediate surgery (with or without reversal), compared to 63/270 (23.3%) for patients taking a DOAC (
conclusionThere is wide variability in Canada in the management of patients with hip fracture receiving anticoagulation. Improved multidisciplinary communication, prospectively evaluated treatment guidelines and focus on knowledge translation may add clarity to this issue. LEVEL OF EVIDENCE: IV.
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