{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:17:45Z","timestamp":1791451065898,"version":"4.3.3"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:00:00Z","timestamp":1744416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:00:00Z","timestamp":1744416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aims to investigate whether early surgery in patients under active DOAC (direct oral anticoagulation) therapy with trochanteric, proximal femur fractures leads to higher postoperative blood loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>A prospective cohort study on DOAC patients with trochanteric, proximal femur fractures undergoing early surgery (\u2264\u200924\u00a0h) was conducted. Propensity score matching with a retrospective control group of DOAC patients with trochanteric, proximal femur fractures undergoing delayed surgery (&gt;\u200924\u00a0h) was performed for comparison. Key outcome measurements included peri- and postoperative blood loss, transfusion rates, time to surgery and hospital length of stay (LOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No differences in the median blood loss in patients undergoing early surgery vs. delayed surgery on postoperative day 1 (1078.35\u00a0ml (IQR 745.86) vs. 1120.79\u00a0ml (IQR 928.50);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.824) or postoperative day 3 (1592.39\u00a0ml (IQR 1304.91) vs. 1339.73\u00a0ml (IQR 735.57);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.165) was seen. No differences in the rate of blood transfusion (72.5% vs. 68.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.576) or the number of transfused red blood cells (RBCs) (2 units (IQR 2) vs. 2 units (IQR 3);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.567) were detected. A significantly longer median time to surgery, and a significantly longer LOS was seen in the delayed surgery group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No difference in the rates of perioperative complications was detected between both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early surgery of trochanteric, proximal femur fractures within 24\u00a0h under active DOAC therapy does not increase postoperative blood loss or the need for postoperative blood transfusions but leads to a significantly shorter length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>IIb<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-025-05870-4","type":"journal-article","created":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T17:21:22Z","timestamp":1744478482000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Early surgical fixation of proximal femur fractures under active direct oral anticoagulation (DOAC) therapy does not increase the postoperative blood loss. 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