Bruckbauer, Martin, Prexl, Oliver, Voelckel, Wolfgang, Ziegler, Bernhard, Grottke, Oliver ORCID: 0000-0002-0722-3122, Maegele, Marc and Schoechl, Herbert (2019). Impact of Direct Oral Anticoagulants in Patients With Hip Fractures. J. Orthop. Trauma, 33 (1). S. E8 - 6. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1531-2291

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Abstract

Objective: To assess the impact of direct oral anticoagulant (DOAC) intake compared with Coumadin (COU) in patients suffering hip fractures (HFs). Design: Retrospective cohort analysis. Setting: Level 1 Trauma Center. Intervention: Timing of surgical hip fixation. Patients: Three-hundred twenty patients 65 years of age or older with isolated HF were enrolled into the study: 207 (64.7%) without any antithrombotic therapy (no-ATT), 59 (18.4%) on COU, and 54 (16.9%) on DOACs. Main Outcome Measurements: Time to surgery, blood loss, mortality, hospital length of stay, red blood cell transfusion, use of reversal agents, and Charlson Comorbidity Index. Results: Patients on COU and DOACs had a higher Charlson Comorbidity Index compared with the no-ATT group (P < 0.0001). Despite the fact that significantly more patients received reversal agents in the COU group compared with DOAC medication (P < 0.0001), percentage of transfused patients were similar (54.2% vs. 53.7%). Time to surgery was significantly shorter in the no-ATT group when compared with DOAC patients (12-29.5 hours, respectively). No difference in postoperative hemorrhage, intensive care unit length of stay, and mortality was observed between groups. Conclusions: DOAC medication in HF patients caused long elapse time until surgical repair. We found no evidence of higher bleeding rates in HF patients on DOACs compared with COUs. Earlier HF fixation might be indicated in DOAC patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bruckbauer, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Prexl, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Voelckel, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ziegler, BernhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grottke, OliverUNSPECIFIEDorcid.org/0000-0002-0722-3122UNSPECIFIED
Maegele, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schoechl, HerbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-138973
DOI: 10.1097/BOT.0000000000001329
Journal or Publication Title: J. Orthop. Trauma
Volume: 33
Number: 1
Page Range: S. E8 - 6
Date: 2019
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1531-2291
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HOSPITAL MORTALITY; VITAMIN-K; WARFARIN; MANAGEMENT; SURGERY; REVERSAL; TIMEMultiple languages
Orthopedics; Sport SciencesMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13897

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