{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:57:10Z","timestamp":1770753430185,"version":"3.50.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6]]},"abstract":"\n Objective:<\/jats:title>\n To evaluate the prehospital use of direct oral anticoagulant (DOAC) agents on the outcomes of early surgical fixation of a geriatric hip fracture.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Case control study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Two academic Level 1 trauma centers.<\/jats:p>\n <\/jats:sec>\n \n Intervention:<\/jats:title>\n Early (<48 h) surgical fixation of a geriatric proximal femur fracture.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n Nineteen patients receiving Pradaxa (dabigatran), Eliquis (apixaban), or Xarelto (rivaroxaban) who underwent surgery between 2010 and 2015 and 74 control patients.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measurements:<\/jats:title>\n Time to surgery, transfusion rates, changes in hemoglobin levels, postoperative complications, readmission rates, and survival out to 1 year.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n There were no differences in transfusions, changes in hemoglobin levels, wound complications, or survival at any time point. Patients on DOAC had a longer delay to reach the operating room (28.9 h v 21.4 h P<\/jats:italic> = 0.03) and were more likely to undergo readmission within 30 days (21% vs. 5.3% P<\/jats:italic> = 0.05). No readmissions occurred for a complication of the surgical site, bleeding, or a venous thromboembolic event.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Geriatric patients with hip fractures receiving DOAC before admission did not demonstrate worse outcomes with early surgical intervention. The increased readmission rate in this population seems attributable to the underlying cardiac conditions for which the patients were receiving anticoagulation. These results suggest that the delay recommended for patients using a DOAC before elective procedures may be unwarranted in the surgically urgent setting of a hip fracture. Additional studies will be necessary for appropriate meta-analysis.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000001146","type":"journal-article","created":{"date-parts":[[2018,2,11]],"date-time":"2018-02-11T13:20:53Z","timestamp":1518355253000},"page":"269-273","source":"Crossref","is-referenced-by-count":53,"title":["Outcomes of Early Surgical Intervention in Geriatric Proximal Femur Fractures Among Patients Receiving Direct Oral Anticoagulation"],"prefix":"10.1097","volume":"32","author":[{"given":"Nathan A.","family":"Franklin","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Brooke Army Medical Center, Sam Houston, TX; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley H.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Florida Orthopaedic Institute\/University of South Florida, Tampa, FL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard K.","family":"Hurley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brooke Army Medical Center, Sam Houston, TX; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan R.","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Florida Orthopaedic Institute\/University of South Florida, Tampa, FL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Beltran","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brooke Army Medical Center, Sam Houston, TX; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1007\/s00228-013-1510-z","article-title":"Novel oral anticoagulants: clinical pharmacology, indications and practical considerations","volume":"69","author":"Harder","year":"2013","journal-title":"Eur J Clin Pharmacol."},{"key":"R6-20230828","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.1365-2125.2011.03916.x","article-title":"Direct thrombin inhibitors","volume":"72","author":"Lee","year":"2011","journal-title":"Br J Clin Pharmacol."},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1515\/cclm-2013-0936","article-title":"Dabigatran, rivaroxaban, apixaban, argatroban and fondaparinux and their effects on coagulation POC and platelet function tests","volume":"52","author":"Eller","year":"2014","journal-title":"Clin Chem Lab Med."},{"key":"R8-20230828","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1056\/NEJMoa1502000","article-title":"Idarucizumab for dabigatran reversal","volume":"373","author":"Pollack","year":"2015","journal-title":"N Engl J Med."},{"issue":"suppl 10","key":"R9-20230828","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/00005131-200711101-00001","article-title":"Fracture and dislocation classification compendium\u20142007: orthopaedic trauma association classification, database outcomes committee","volume":"21","author":"Marsh","year":"2007","journal-title":"J Orthop Trauma."},{"key":"R10-20230828","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1097\/BOT.0b013e318240d70f","article-title":"The effects of clopidogrel (plavix) and other oral anticoagulants on early hip fracture surgery","volume":"26","author":"Collinge","year":"2012","journal-title":"J Orthop Trauma."},{"key":"R11-20230828","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/j.injury.2015.03.024","article-title":"Is early hip fracture surgery safe for patients on clopidogrel? 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