{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:07:18Z","timestamp":1790647638808,"version":"4.1.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T00:00:00Z","timestamp":1569024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T00:00:00Z","timestamp":1569024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>The management of patients with a hip fracture is affected by the use of oral anticoagulants. A cross-sectional analysis was undertaken to investigate health outcome differences in those anticoagulated compared to those not anticoagulated.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients aged 50\u00a0years and over presenting to a large university hospital with hip fractures were identified from the service registry. Patient characteristics and health outcomes between those not anticoagulated were compared with those anticoagulated (warfarin and direct oral anticoagulants, DOAC).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>200\/2307 (9%) patients were anticoagulated. 84% were on warfarin, and the rest a DOAC. Compared to those anticoagulated, there was a higher prevalence of dementia (25% vs. 18%, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and a lower prevalence of cardiovascular disease (54% vs. 78%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), atrial fibrillation (10% vs. 82%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and polypharmacy (55% vs. 76%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Renal function was lower in the anticoagulated group. Time to operation for those not anticoagulated and anticoagulated was a median (IQR) of 25 (15) and 27 (18) hours. There was no difference in blood transfusion and hospital mortality. Postoperative complications were similar except a higher rate of renal failure (14% vs. 19%, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and heart failure (1% vs. 5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and a longer length of stay [median (IQR): 14 (10) vs. 16 (12) days] in the anticoagulated group. This was no longer significant after adjustment of confounders.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>There was no statistically significant difference in health outcomes between those anticoagulated and those not after adjusting for patient characteristics. It was feasible to avoid significant delay in hip fracture surgery in those anticoagulated.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00402-019-03240-5","type":"journal-article","created":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T12:02:28Z","timestamp":1569067348000},"page":"171-176","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Do anticoagulants affect outcomes of hip fracture surgery? A cross-sectional analysis"],"prefix":"10.1007","volume":"140","author":[{"given":"Caroline","family":"Hoerlyck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merete","family":"Gregersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Else Marie","family":"Damsgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Borris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jac Kie","family":"Chia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying Yi Wendy","family":"Yap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namal","family":"Weerasuriya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Opinder","family":"Sahota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,21]]},"reference":[{"key":"3240_CR1","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s11657-012-0100-5","volume":"7","author":"SW Wade","year":"2012","unstructured":"Wade SW, Strader C, Fitzpatrick LA, Anthony MS (2012) Sex- and age-specific incidence of non-traumatic fractures in selected industrialized countries. Arch Osteoporos 7:219\u2013227","journal-title":"Arch Osteoporos"},{"key":"3240_CR2","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1007\/PL00004148","volume":"7","author":"B Gullberg","year":"1997","unstructured":"Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407\u2013413","journal-title":"Osteoporos Int"},{"key":"3240_CR3","unstructured":"Hip fracture: management (2011) Clinical guideline. \nhttps:\/\/www.nice.org.uk\/guidance\/cg124\n\n. Accessed 21 Jan 2018"},{"issue":"Suppl 4","key":"3240_CR4","doi-asserted-by":"publisher","first-page":"S529","DOI":"10.1007\/s00198-010-1391-2","volume":"21","author":"F Leung","year":"2010","unstructured":"Leung F, Lau T, Kwan K, Chow S, Kung A (2010) Does timing of surgery matter in fragility hip fractures? Osteoporos Int 21(Suppl 4):S529\u2013S534","journal-title":"Osteoporos Int"},{"issue":"Suppl 4","key":"3240_CR5","doi-asserted-by":"publisher","first-page":"S91","DOI":"10.1016\/j.injury.2016.07.055","volume":"47","author":"F Rosso","year":"2016","unstructured":"Rosso F, Dettoni F, Bonasia DE et al (2016) Prognostic factors for mortality after hip fracture: operation within 48 hours is mandatory. Injury 47(Suppl 4):S91\u2013S97","journal-title":"Injury"},{"issue":"7","key":"3240_CR6","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.2106\/JBJS.G.00890","volume":"90","author":"AN Al-Ani","year":"2008","unstructured":"Al-Ani AN, Samuelsson B, Tidermark J et al (2008) Early operation on patients with a hip fracture improved the ability to return to independent living. A prospective study of 850 patients. J Bone Jt Surg Am 90(7):1436\u20131442","journal-title":"J Bone Jt Surg Am"},{"issue":"8","key":"3240_CR7","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1097\/BOT.0000000000000313","volume":"29","author":"DJ Ryan","year":"2015","unstructured":"Ryan DJ, Yoshihara H, Yoneoka D, Egol KA, Zuckerman JD (2015) Delay in hip fracture surgery: an analysis of patient-specific and hospital-specific risk factors. J Orthop Trauma 29(8):343\u2013348","journal-title":"J Orthop Trauma"},{"issue":"10","key":"3240_CR8","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.2106\/00004623-199510000-00010","volume":"77","author":"JD Zuckerman","year":"1995","unstructured":"Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH (1995) Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Jt Surg Am 77(10):1551\u20131556","journal-title":"J Bone Jt Surg Am"},{"issue":"3","key":"3240_CR9","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1007\/BF03016088","volume":"55","author":"T Shiga","year":"2008","unstructured":"Shiga T, Wajima Z, Ohe Y (2008) Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression. Can J Anaesth 55(3):146\u2013154","journal-title":"Can J Anaesth"},{"key":"3240_CR10","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1097\/01.blo.0000146743.28925.1c","volume":"428","author":"KJ McGuire","year":"2004","unstructured":"McGuire KJ, Bernstein J, Polsky D, Silber JH (2004) The 2004 Marshall Urist award: delays until surgery after hip fracture increases mortality. Clin Orthop Relat Res 428:294\u2013301","journal-title":"Clin Orthop Relat Res"},{"issue":"7","key":"3240_CR11","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1302\/0301-620X.91B7.22446","volume":"91","author":"KA Lefaivre","year":"2009","unstructured":"Lefaivre KA, Macadam SA, Davidson DJ, Gandhi R, Chan H, Broekhuyse HM (2009) Length of stay, mortality, morbidity and delay to surgery in hip fractures. J Bone Jt Surg Br 91(7):922\u2013927","journal-title":"J Bone Jt Surg Br"},{"issue":"15","key":"3240_CR12","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1503\/cmaj.092220","volume":"182","author":"N Simunovic","year":"2010","unstructured":"Simunovic N, Devereaux PJ, Sprague S et al (2010) Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ 182(15):1609\u20131616","journal-title":"CMAJ"},{"issue":"20","key":"3240_CR13","doi-asserted-by":"publisher","first-page":"1994","DOI":"10.1001\/jama.2017.17606","volume":"318","author":"D Pincus","year":"2017","unstructured":"Pincus D, Ravi B, Wasserstein D et al (2017) Association between wait time and 30-day mortality in adults undergoing hip fracture surgery. JAMA 318(20):1994\u20132003","journal-title":"JAMA"},{"issue":"3","key":"3240_CR14","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.surge.2010.11.031","volume":"9","author":"MP Fantini","year":"2011","unstructured":"Fantini MP, Fabbri G, Laus M et al (2011) Determinants of surgical delay for hip fracture. Surgeon 9(3):130\u2013134","journal-title":"Surgeon"},{"issue":"3","key":"3240_CR15","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1177\/2151458514532469","volume":"5","author":"WG Eardley","year":"2014","unstructured":"Eardley WG, Macleod KE, Freeman H, Tate A (2014) \u201cTiers of delay\u201d: warfarin, hip fractures, and target-driven care. Geriatr Orthop Surg Rehabil 5(3):103\u2013108","journal-title":"Geriatr Orthop Surg Rehabil"},{"issue":"5","key":"3240_CR16","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1016\/j.thromres.2015.09.017","volume":"136","author":"T Tran","year":"2015","unstructured":"Tran T, Delluc A, de Wit C, Petrcich W, Le Gal G, Carrier M (2015) The impact of oral anticoagulation on time to surgery in patients hospitalized with hip fracture. Thromb Res 136(5):962\u2013965","journal-title":"Thromb Res"},{"issue":"1","key":"3240_CR17","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1007\/s11999-016-5056-0","volume":"475","author":"JE Lawrence","year":"2017","unstructured":"Lawrence JE, Fountain D, Cundall-Curry D, Carrothers A (2017) Do patients taking warfarin experience delays to theatre, longer hospital stay, and poorer survival after hip fracture? Clin Orthop Relat Res 475(1):273\u2013279","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"3240_CR18","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3810\/hp.2011.02.372","volume":"39","author":"AH Ranhoff","year":"2011","unstructured":"Ranhoff AH, Martinsen MI, Holvik K, Solheim LF (2011) Use of warfarin is associated with delay in surgery for hip fracture in older patients. Hosp Pract 39(1):37\u201340","journal-title":"Hosp Pract"},{"issue":"9","key":"3240_CR19","doi-asserted-by":"publisher","first-page":"2096","DOI":"10.1111\/bcp.13299","volume":"83","author":"SY Loo","year":"2017","unstructured":"Loo SY, Dell\u2019Aniello S, Huiart L, Renoux C (2017) Trends in the prescription of novel oral anticoagulants in UK primary care. Br J Clin Pharmacol 83(9):2096\u20132106","journal-title":"Br J Clin Pharmacol"},{"issue":"1","key":"3240_CR20","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1111\/jgs.12591","volume":"62","author":"LJ Gleason","year":"2014","unstructured":"Gleason LJ, Mendelson DA, Kates SL, Friedman SM (2014) Anticoagulation management in individuals with hip fracture. J Am Geriatr Soc 62(1):159\u2013164","journal-title":"J Am Geriatr Soc"},{"issue":"10","key":"3240_CR21","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1093\/europace\/euv309","volume":"17","author":"H Heidbuchel","year":"2015","unstructured":"Heidbuchel H, Verhamme P, Alings M et al (2015) Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 17(10):1467\u20131507","journal-title":"Europace"},{"key":"3240_CR22","doi-asserted-by":"publisher","first-page":"e020625","DOI":"10.1136\/bmjopen-2017-020625","volume":"8","author":"B Mullins","year":"2018","unstructured":"Mullins B, Akehurst H, Slattery D, Chesser T (2018) Should surgery be delayed in patients taking direct oral anticoagulants who suffer a hip fracture? A retrospective, case-controlled observational study at a UK major trauma centre. BMJ Open 8:e020625","journal-title":"BMJ Open"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-019-03240-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00402-019-03240-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-019-03240-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T23:31:12Z","timestamp":1600558272000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00402-019-03240-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,21]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["3240"],"URL":"https:\/\/doi.org\/10.1007\/s00402-019-03240-5","relation":{},"ISSN":["0936-8051","1434-3916"],"issn-type":[{"value":"0936-8051","type":"print"},{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,21]]},"assertion":[{"value":"24 January 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2019","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest related to this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}