ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023
Role of DOAC plasma concentration on perioperative blood loss and transfusion requirements in patients with hip fractures.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Perioperative management of direct oral anticoagulant-treated patients who need urgent surgery.Research and practice in thrombosis and haemostasis · 2026Article
- Transfusion and mortality after major trauma in patients on direct oral anticoagulants: a multicentre cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Direct oral anticoagulant plasma concentrations according to the time elapsed since the last dose and to renal function: a retrospective study in geriatric patients with hip fractures.European journal of anaesthesiology and intensive care · 2026Article
- [Point of care coagulation diagnostics-Absolutely necessary or only a reasonable supplement?]Die Anaesthesiologie · 2025Review
- Management of hip fracture patients on direct oral anticoagulants: a survey of orthopaedic trauma surgeons, systematic review, and meta-analysis.OTA international : the open access journal of orthopaedic trauma · 2025Article
- The management of anticoagulated fragility femoral fracture patients.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2024Review
- [Update on point-of-care-based coagulation treatment : Systems, reagents, device-specific treatment algorithms].Die Anaesthesiologie · 2024Review
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9 authors.
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Abstract
backgroundThere is an ever-increasing number of hip fracture (HF) patients on direct oral anticoagulants (DOAC). The impact of DOAC plasma level prior to HF surgery on perioperative blood loss and transfusion requirements has not been investigated so far. MATERIALS AND
methodsIn this retrospective study of HF patients on DOACs admitted to the AUVA Trauma Center Salzburg between February 2015 and December 2021. DOAC plasma levels were analysed prior to surgery. Patients were categorized into four DOAC groups: Group A < 30 ng/mL, Group B 30-49 ng/mL, Group C 50-79 ng/mL, and Group D ≥ 80 ng/mL. Haemoglobin concentration was measured upon admission, prior to surgery, after ICU/IMC admission, and on day 1 and 2 post-surgery. Difference in the blood loss via drains, transfusion requirements and time to surgery were compared.
resultsA total of 155 subjects fulfilled the predefined inclusion criteria. The median age of the predominantly female patients was 86 (80-90) years. Haemoglobin concentration in Group D was lower upon admissions but did not reach statistical significance. The decrease in haemoglobin concentration over the entire observation time was comparable between groups. Blood transfusion requirements were significantly higher in Group D compared to Group A and B (p = 0.0043). Time to surgery, intra- and postoperative blood loss via drains were not different among groups.
conclusionNo strong association between the DOAC plasma levels and perioperative blood loss was detected. Higher transfusion rates in patients with DOAC levels ≥ 80 ng/mL were primarily related to lower admission haemoglobin levels. DOAC concentration measurement is feasible and expedites time to surgery.
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