{"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":1791451065152,"version":"4.3.3"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"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":["Eur Geriatr Med"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The perioperative consequences of direct oral anticoagulants (DOACs) in hip fracture patients are not sufficiently investigated. The primary aim of this study was to determine whether DOAC-users have delayed surgery compared to non-users. Secondarily, we studied whether length of hospital stay, mortality, reoperations and bleeding complications were influenced by the use of DOAC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The medical records of 314 patients operated for a hip fracture between 2016 and 2017 in a single trauma center were assessed. Patients aged\u2009&lt;\u200960 and patients using other forms of anticoagulation than DOACs were excluded. Patients were followed from admission to 6\u00a0months postoperatively. Surgical delay was defined as time from admission to surgery. Secondary outcomes included length of hospital stay, transfusion rates, perioperative bleeding loss, postoperative wound ooze, mortality and risk of reoperation. The use of general versus neuraxial anaesthesia was registered. Continuous outcomes were analysed using Students <jats:italic>t<\/jats:italic> test, while categorical outcomes were expressed by Odds ratios.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>47 hip fracture patients (15%) were using DOACs. No difference in surgical delay (29 vs 26\u00a0h, <jats:italic>p<\/jats:italic>\u2009=\u20090.26) or length of hospital stay (6.6 vs 6.1\u00a0days, <jats:italic>p<\/jats:italic>\u2009=\u20090.34) were found between DOAC-users and non-users. DOAC-users operated with neuraxial anaesthesia had longer surgical delay compared to DOAC-users operated with general anaesthesia (35\u00a0h vs 22\u00a0h, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Perioperative blood loss, transfusion rate, risk of bleeding complications and mortality were similar between groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Hip fracture patients using DOAC did not have increased surgical delay, length of stay or risk of reported bleeding complications than patients without anticoagulation prior to surgery. The increased surgical delay found for DOAC-users operated with neuraxial anaesthesia should be interpreted with caution.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s41999-020-00319-w","type":"journal-article","created":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T11:03:31Z","timestamp":1588417411000},"page":"563-569","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Do direct oral anticoagulants (DOACs) cause delayed surgery, longer length of hospital stay, and poorer outcome for hip fracture patients?"],"prefix":"10.1007","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-7096","authenticated-orcid":false,"given":"Sunniva","family":"Leer-Salvesen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6886-9701","authenticated-orcid":false,"given":"Eva","family":"Dybvik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8690-4753","authenticated-orcid":false,"given":"Anette H.","family":"Ranhoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8652-6438","authenticated-orcid":false,"given":"Bj\u00f8rn Liljestrand","family":"Huseb\u00f8","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola E.","family":"Dahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3126-3164","authenticated-orcid":false,"given":"Lars B.","family":"Enges\u00e6ter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8490-268X","authenticated-orcid":false,"given":"Jan-Erik","family":"Gjertsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"319_CR1","unstructured":"No authors listed (2019) Norwegian Institute of Public Health, The prescription registry. 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The hospital data protection officer approved the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Our study involves hip fracture patients with a 1\u00a0year mortality of 25% and an even larger prevalence of cognitive impairment. We have performed a descriptive study using patient records without consent due to the patient demographics (age, mortality and cognitive impairment) by conducting a risk assessment taking into account the potential gain in quality of future patient treatment. The Regional Ethics Committee (REK) classified the study as quality assurance, thus we did not need ethical assessment (case number 1366\/REK). The hospital data protection officer approved the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The hospital data protection officer approved the study. We refer to the classification from the Regional Ethics Committee.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Our data have been deidentified and stored in a secure server area only available for Eva Dybvik and Sunniva Leer-Salvesen. The data will be deleted 5\u00a0years after the study.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and material"}},{"value":"IBM SPSS Statistics (version 24.0; IBM Corp. Armonk, New York) for Windows was used for the statistical analyses.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}}]}}