Evidence map›Paper›PMID 41288746›Full record

Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Clinical outcomes in elderly patients on direct oral anticoagulant drugs undergoing surgery for acute hip fracture (AHF).

Elsa Wemmert, Pernilla Eklöf, Victor Linder, Emilia Möller Rydberg, Keti Dalla, Bengt Nellgård, Fredrik Hessulf, Adam Piasecki

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

8 authors.

Elsa WemmertInstitute of Clinical Sciences, Department of Anaesthesiology and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0009-0006-5361-2483
Pernilla EklöfInstitute of Clinical Sciences, Department of Anaesthesiology and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Victor LinderDepartment of Internal Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Göteborgsvägen 31, Mölndal, 43130, Sweden.ORCID http://orcid.org/0009-0004-1833-3150
Emilia Möller RydbergInstitute of Clinical Sciences, Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-0813-4508
Keti DallaInstitute of Clinical Sciences, Department of Anaesthesiology and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0001-7367-2500
Bengt NellgårdInstitute of Clinical Sciences, Department of Anaesthesiology and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0001-6791-8893
Fredrik HessulfInstitute of Clinical Sciences, Department of Anaesthesiology and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-2730-8710
Adam PiaseckiInstitute of Clinical Sciences, Department of Anaesthesiology and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. adam.piasecki@gu.se.ORCID http://orcid.org/0000-0002-5088-169X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

methodsThis single-center retrospective observational study analyzed 594 elderly acute hip fracture (AHF) patients surgically treated in 2023. The primary aim was to determine if direct oral anticoagulant (DOAC) therapy in elderly AHF patients is associated with higher mortality 360 days after surgery. Secondary aims were to assess whether DOAC-users have a longer time to surgery and/or higher transfusion requirements than non-users. Numerical outcomes were analyzed using the Mann-Whitney U test, and categorical outcomes using the Chi-squared test. To analyze mortality, Kaplan-Meier survival curves and multivariate Cox regression were used.

results170 AHF patients (28.6%) were treated with DOACs. DOAC-users had a higher mortality 360 days after surgery compared to non-users (35.9% vs. 16.7%, p < 0.001). This association remained significant after adjusting for covariates (HR = 1.57, p = 0.02). Further, patients using DOACs had a longer time to start of surgery (24.6 h vs. 22.6 h, p = 0.0048) and higher transfusion rates (51.2% vs. 39.4%, p = 0.009), while transfusion volumes did not differ (p = 0.091).

conclusionSurgically treated acute hip fracture patients on DOACs had higher 360-day mortality, adjusted for age, sex, comorbidity and frailty. Additionally, these patients experienced longer time to surgery and higher transfusion rates. This study provides important insights into the perioperative outcomes of elderly AHF patients using DOACs and highlights the need for further research.

Indexed as

AnticoagulantsHip FracturesAdministration, OralAgedAged, 80 and overBlood TransfusionFemaleHumansMaleRetrospective StudiesTime-to-TreatmentTreatment OutcomeAnticoagulantsAcute hip fractureAnticoagulantsDirect oral anticoagulantsDOACGeriatric patientsMortality

Identifiers

PMID41288746
PMCPMC12647338

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Registered trials

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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.