ReviewCureus2025
Perioperative Outcomes With Direct Oral Anticoagulants in Orthopaedic Trauma Surgery: A Systematic Review and Meta-Analysis.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The perioperative management of direct oral anticoagulants (DOACs) in orthopaedic trauma is variably practised. We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-concordant systematic review and meta-analysis of adult trauma surgery comparing DOAC exposure with vitamin K antagonists or no anticoagulation. MEDLINE, Embase, and CENTRAL were searched (2010-October 2025) for randomised and observational studies. Pre-injury DOAC use informed analyses of mortality, transfusion, and operative delay, whereas postoperative prophylaxis trials addressed venous thromboembolism (VTE); these represent two distinct clinical questions that were analysed separately. Risk of bias (Risk of Bias 2/Risk of Bias in Non-randomized Studies - of Interventions), random-effects pooling, and GRADE were used. In total, 15 studies (4 randomised, 11 observational; >6,000 patients) were included. DOAC exposure was not associated with higher mortality (risk ratio (RR) = 0.98, 95% confidence interval (CI) = 0.66-1.45), transfusion (RR = 1.20, 95% CI = 0.96-1.49), or VTE (RR = 0.41, 95% CI = 0.16-1.05). DOAC users more often experienced operative delay beyond 24-36 hours (RR = 2.43, 95% CI = 0.93-6.33), which may reflect institutional caution. Evidence certainty ranged from low to moderate. In orthopaedic trauma, DOAC use is not linked to increased perioperative bleeding, transfusion, VTE, or mortality, but is associated with modest surgical delay. Where renal function is adequate and no active bleeding exists, early fixation without routine pharmacological reversal appears safe. Standardised early-surgery pathways and education on DOAC pharmacokinetics may reduce avoidable delays.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.