{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:56:35Z","timestamp":1787064995444,"version":"build-2736575974"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T00:00:00Z","timestamp":1606435200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T00:00:00Z","timestamp":1606435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum GmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Unfallchirurg"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund und Fragestellung<\/jats:title>\n                    <jats:p>Proximale Femurfrakturen stellen mit ca.\u00a0100.000 Betroffenen\/Jahr in Deutschland ein h\u00e4ufiges Krankheitsbild dar. Durch eine zeitnahe Versorgung (&lt;24\u202fh) konnte die Mortalit\u00e4t erheblich gesenkt werden. Ziele der Arbeit waren, die Pr\u00e4valenz der Antikoagulation und hiermit assoziierte Komplikationen bei osteosynthetisch versorgter, proximaler Femurfraktur und deren Impact auf die pr\u00e4operative Verweildauer zu analysieren und Potenziale zum optimalen perioperativen Gerinnungsmanagements aufzuzeigen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Die Daten der externen vergleichenden Qualit\u00e4tssicherung Nordrhein-Westfalen f\u00fcr die Jahre 2015 und 2016 wurden ausgewertet. Dabei wurden ausschlie\u00dflich F\u00e4lle analysiert, bei denen eine h\u00fcftgelenknahe Femurfraktur osteosynthetisch versorgt wurde. Insgesamt wurden 24.786 F\u00e4lle h\u00fcftgelenknaher Femurfrakturen in die Studie eingeschlossen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>\n                      Von den Patienten mit einer antithrombotischen Dauertherapie (ATDT) wurden in der gr\u00f6\u00dften Subgruppe mit ASS-Medikation (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u20094005) 17\u202f%, in der zweitgr\u00f6\u00dften Gruppe mit Vitamin-K-Antagonisten-Einnahme (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u20092157) 44,6\u202f% und in der drittgr\u00f6\u00dften Gruppe mit Einnahme von direkten oralen Antikoagulanzien (DOAKs,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u2009994) 18,2\u202f% verz\u00f6gert operiert.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerungen<\/jats:title>\n                    <jats:p>Das gr\u00f6\u00dfte Potenzial zur Verk\u00fcrzung der pr\u00e4operativen Verweildauer ergibt sich in der Gruppe der Patienten, die ASS (17\u202f% auff\u00e4llig) oder einen Vitamin-K-Antagonisten (VKA, 44,6\u202f% auff\u00e4llig) einnehmen. Eine Antagonisierung der Wirkung von VKA l\u00e4sst sich innerhalb kurzer Zeit durch die Gabe von Prothrombinkomplex (PPSB) erreichen. Auch unter der Einnahme von DOAKs muss das noch g\u00e4ngige Prozedere einer verz\u00f6gerten operativen Versorgung kritisch hinterfragt werden. Die Etablierung eines Gerinnungsmanagements ist zu fordern. Neben der medizinischen Intervention (Gabe von Antidota) m\u00fcssen Strukturen geschaffen werden, die eine zeitnahe Versorgung erm\u00f6glichen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00113-020-00923-2","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T08:19:10Z","timestamp":1606465150000},"page":"642-650","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Proximale osteosynthetisch versorgte Femurfrakturen: Der Versorgungszeitpunkt verz\u00f6gert sich bei vorbestehender Antikoagulation","Osteosynthetic treatment of proximal femoral fractures: the timing of treatment is delayed in cases of pre-existing anticoagulation"],"prefix":"10.1007","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2213-4133","authenticated-orcid":false,"given":"J. 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F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}