{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T08:36:52Z","timestamp":1771058212382,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Es wird international \u00fcber den optimalen Operationszeitpunkt \u00e4lterer Patienten mit proximaler Femurfraktur diskutiert. Eine vorbestehende Antikoagulation scheint ein wesentlicher Grund f\u00fcr die Verz\u00f6gerung der operativen Frakturbehandlung zu sein. Ziel dieser Studie war es, die Komplikations- und Sterblichkeitsraten bei \u00e4lteren, antikoagulierten H\u00fcftfrakturpatienten zu untersuchen, die zeitgerecht (&lt;\u00a024\u00a0h) bzw. verz\u00f6gert (&gt;\u00a024\u00a0h) operiert wurden.<\/jats:p><jats:p>Unsere Analyse basiert auf Daten der externen station\u00e4ren Qualit\u00e4tssicherung aus Nordrhein-Westfalen als bev\u00f6lkerungsreichstem deutschen Bundesland. Wir identifizierten 13201 Patienten mit proximaler Femurfraktur unter gerinnungsaktiver Medikation und einem Mindestalter von 65 Jahren, die von Januar 2015 bis Dezember 2017 behandelt wurden.<\/jats:p><jats:p>Eine verz\u00f6gerte Operation war mit signifikant h\u00f6heren Komplikations- und Mortalit\u00e4tsraten verbunden. Mit Ausnahme einer vorbestehenden Herzinsuffizienz konnten keine Komorbidit\u00e4ten identifiziert werden, die einen klaren Hinweis darauf geben k\u00f6nnten, warum eine Operationsverz\u00f6gerung eingetreten ist.<\/jats:p><jats:p>In den meisten F\u00e4llen ist bei Patienten mit gerinnungsaktiver Medikation aufgrund schwerwiegender Begleiterkrankungen insgesamt mit einem schlechteren Behandlungsergebnis zu rechnen. Wurden diese Patienten versp\u00e4tet operiert, waren die Behandlungsergebnisse nochmals deutlich schlechter. Um das Risiko von Komplikationen zu verringern, sollte daher eine Operation mit einer Verz\u00f6gerung von &gt;\u00a024\u00a0h vermieden werden.<\/jats:p>","DOI":"10.1055\/a-2324-1877","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T23:00:41Z","timestamp":1718751641000},"page":"44-52","source":"Crossref","is-referenced-by-count":1,"title":["Gerinnungsaktive Medikation bei endoprothetisch versorgter proximaler Femurfraktur - Komplikationen und Mortalit\u00e4t unter Ber\u00fccksichtigung des Versorgungszeitpunktes als Qualit\u00e4tskriterium"],"prefix":"10.1055","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7444-0410","authenticated-orcid":false,"given":"Christoph Johannes","family":"Neumann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfallchirurgie und Orthop\u00e4die, Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim Dario","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfallchirurgie und Orthop\u00e4die, Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00fcdiger","family":"Smektala","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfallchirurgie und Orthop\u00e4die, Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"ref5","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1503\/cmaj.092220","article-title":"Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis","volume":"182","author":"N Simunovic","year":"2010","journal-title":"CMAJ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"13933","DOI":"10.1038\/s41598-018-32098-7","article-title":"Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis","volume":"8","author":"T Klestil","year":"2018","journal-title":"Sci Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1302\/0301-620X.101B9.BJJ-2019-0295.R1","article-title":"Does time from fracture to surgery affect mortality and intraoperative medical complications for hip fracture patients? 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