Key result
Direct oral anticoagulants significantly delayed time to surgery for hip fracture patients compared to warfarin and controls (66±16 hours vs 38±21 and 25±19 hours, respectively; P<0.05).
Why the study?
Does DOAC use delay time to surgery in operative hip fracture patients compared to warfarin or control?
Observational (n=55)
Does DOAC use delay time to surgery in operative hip fracture patients compared to warfarin or control?
Absolute Event Rate: 66% vs 25%
p-value: p=<0.05
DOAC use significantly delays time to surgery in hip fracture patients compared to warfarin or no anticoagulation, presenting a barrier to optimal perioperative care.
DOAC use may delay hip fracture surgery; leaves open optimal reversal strategies in anticoagulated patients.
Rapid surgical management of hip fracture patients is critical to reduce morbidity and mortality. These patients may be anticoagulated and the new direct oral anticoagulants (DOAC) may introduce delays to treatment. Our purpose was to examine the impact of these DOAC on time to surgical management for hip fracture patients. Methods A prospective audit of 55 consecutive operative hip fracture patients examined time from diagnosis to surgery. Indications for anticoagulation were recorded. Results Time to surgery for the DOAC group was 66±16 hours, versus 38±21 and 25±19 hours for warfarin and control groups, respectively (P<0.05). Anticoagulation was for atrial fibrillation in 93%. Conclusion Patients on DOAC faced significant delays to surgery. Given that both DOAC use and incidence of hip fracture are expected to rise, this presents a barrier to optimized care in this vulnerable group.
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Sabo et al. (2018) conducted an observational in Hip fracture (n=55). Direct oral anticoagulants (DOAC) vs. Warfarin and control groups was evaluated on Time from diagnosis to surgery (p=<0.05). Direct oral anticoagulants significantly delayed time to surgery for hip fracture patients compared to warfarin and controls (66±16 hours vs 38±21 and 25±19 hours, respectively; P<0.05).
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