ArticleEuropean journal of anaesthesiology and intensive care2026
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.
Article in European journal of anaesthesiology and intensive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEarly surgery for hip fractures in elderly patients is recommended to reduce morbidity and mortality. In patients treated with direct oral anticoagulants (DOACs), early surgical management raises pharmacological and safety concerns. Current guidelines recommend using plasma anticoagulant levels to guide perioperative management, but data describing the time course of DOAC plasma concentrations after the last dose in geriatric patients with hip fracture remain limited.
objectivesTo describe the time course of DOAC plasma concentrations according to the estimated time since last intake in elderly patients admitted for hip fracture, and to compare residual concentrations at 24 h between patients with preserved and impaired renal function.
designSingle-centre retrospective observational study.
settingSecondary care hospital; emergency admissions for hip fracture surgery. Study period: January 1st, 2022 to March 31st, 2025. PATIENTS: Patients aged ≥65 years treated with DOACs and admitted for hip fracture following a low-energy traumatic event. Patients receiving inappropriate DOAC dosing or DOACs despite formal contraindications were excluded from the main analysis.
interventionsNone.
main outcome measuresThe primary outcome was the proportion of patients with a plasma DOAC concentration ≥100 ng ml
resultsData from 186 patients were analysed. Among patients with eGFR ≥50 ml min
conclusionsMost elderly patients with preserved renal function had plasma DOAC concentrations below 100 ng ml
trial registrationNot applicable (retrospective observational study).
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