{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:57:54Z","timestamp":1790215074452,"version":"4.1.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Diakonhjemmet Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Treatment with direct-acting oral anticoagulants (DOACs) is increasing among hip-fracture patients, with accompanying safety concerns regarding spinal anesthesia (SA). The aim of this study was to investigate if DOAC use is associated with increased waiting time before surgery, increased mortality, or other adverse events.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Registry data on surgically treated hip-fracture cases at a single hospital between 2015 and 2021 were analyzed. Multivariable regression analyses were performed with DOAC-status and choice of anesthesia as exposures, and waiting time, length of stay, transfusion, and mortality as outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>2885 cases were included, 467 patients (16%) were using DOACs. DOAC users were older (86.3 vs. 82.2\u00a0years, p\u2009&lt;\u20090.001), had a higher Charlson Comorbidity Index (2.1 vs. 1.5, p\u2009&lt;\u20090.001) and had longer median time to surgery than non-DOAC cases (36\u00a0h vs 17\u00a0h, p\u2009&lt;\u20090.001). General anesthesia (GA) was used in 19.3% of DOAC patients and in 3.0% of non-DOAC patients. DOAC-patients had an increased risk of one-month mortality (Adjusted Odds Ratio (AOR) 1.6 (1.1\u20132.3)) and one-year mortality (AOR 1.4 (1.1\u20131.8)). There were no differences in risk of blood transfusion. Patients on DOAC operated under GA had a lower risk of one-year mortality (AOR 0.5 (0.3\u20130.9)), but a similar one-month mortality to DOAC-patients operated under SA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>DOAC users had a longer waiting time to surgery, indicating postponement of surgery due to concerns of the safety of SA. The clinical practice should be changed to allow earlier surgery for DOAC patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-024-02532-9","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T09:01:54Z","timestamp":1715072514000},"page":"1851-1857","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Use of direct-acting anticoagulants (DOACs) delays surgery and is associated with increased mortality in hip fracture patients"],"prefix":"10.1007","volume":"50","author":[{"given":"Mads","family":"Sundet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Sundin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aasmund","family":"God\u00f8","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Sydnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haldor","family":"Valland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Sexton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Martinsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Paus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Schmidt","family":"Rasmussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siri","family":"Lillegraven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"2532_CR1","doi-asserted-by":"publisher","first-page":"2527","DOI":"10.1007\/s00198-011-1888-3","volume":"23","author":"R St\u00f8en","year":"2012","unstructured":"St\u00f8en R, Nordsletten L, Meyer HE, Frihagen JF, Falch JA, Lofthus CM. Hip fracture incidence is decreasing in the high incidence area of Oslo. Norway Osteoporos Int. 2012;23:2527\u201334.","journal-title":"Norway Osteoporos Int"},{"key":"2532_CR2","unstructured":"National institute for Health and Care Excellence (NICE). Hip fracture: management (CG124) [Internet]. Clin. Guidel. 2011. p. d2108. Available from: https:\/\/www.nice.org.uk\/guidance\/cg124\/resources\/hip-fracture-management-pdf-35109449902789. Accessed 01-03-2024."},{"key":"2532_CR3","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1302\/0301-620X.101B9.BJJ-2019-0295.R1","volume":"101-B","author":"S Leer-Salvesen","year":"2019","unstructured":"Leer-Salvesen S, Enges\u00e6ter LB, Dybvik E, Furnes O, Kristensen TB, Gjertsen JE. Does time from fracture to surgery affect mortality and intraoperative medical complications for hip fracture patients? An observational study of 73 557 patients reported to the Norwegian hip fracture register. 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