Management of ongoing direct anticoagulant treatment in patients with hip fracture

Management of ongoing direct anticoagulant treatment in patients with hip fracture

Abstract Aim of the present study was to investigate the effects of ongoing treatment with DOACs on time from trauma to surgery and on in-hospital clinical outcomes (blood losses, need for transfusion, mortality) in patients with hip fracture. Moreover we evaluated the adherence to current guideline...

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Autores principales: Carlo Rostagno, Alessandro Cartei, Gianluca Polidori, Roberto Civinini, Alice Ceccofiglio, Gaia Rubbieri, Massimo Curcio, Alberto Boccaccini, Adriano Peris, Domenico Prisco
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Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/af64a737e4464649a285bdd76e81aec5
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spelling oai:doaj.org-article:af64a737e4464649a285bdd76e81aec52021-12-02T15:38:10ZManagement of ongoing direct anticoagulant treatment in patients with hip fracture10.1038/s41598-021-89077-82045-2322https://doaj.org/article/af64a737e4464649a285bdd76e81aec52021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89077-8https://doaj.org/toc/2045-2322Abstract Aim of the present study was to investigate the effects of ongoing treatment with DOACs on time from trauma to surgery and on in-hospital clinical outcomes (blood losses, need for transfusion, mortality) in patients with hip fracture. Moreover we evaluated the adherence to current guidelines regarding the time from last drug intake and surgery. In this observational retrospective study clinical records of patients admitted for hip fracture from January 2016 to January 2019 were reviewed. 74 patients were in treatment with DOACs at hospital admission. Demographic data, comorbidities and functional status before trauma were retrieved. As control group we evaluated 206 patients not on anticoagulants matched for age, gender, type of fracture and ASA score. Time to surgery was significantly longer in patients treated with DOACs (3.6 + 2.7 vs. 2.15 ± 1.07 days, p < 0.0001) and treatment within 48 h was 47% vs. 80% in control group (p < 0.0001). The adherence to guidelines’ suggested time from last drug intake to surgery was 46%. Neither anticipation nor delay in surgery did result in increased mortality, length of stay or complication rates with the exception of larger perioperative blood loss (Hb levels < 8 g/dl) in DOACs patients (34% vs 9% p < 0.0001). Present results suggest that time to surgery is significantly longer in DOAC patients in comparison to controls and adherence to guidelines still limited.Carlo RostagnoAlessandro CarteiGianluca PolidoriRoberto CivininiAlice CeccofiglioGaia RubbieriMassimo CurcioAlberto BoccacciniAdriano PerisDomenico PriscoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Carlo Rostagno
Alessandro Cartei
Gianluca Polidori
Roberto Civinini
Alice Ceccofiglio
Gaia Rubbieri
Massimo Curcio
Alberto Boccaccini
Adriano Peris
Domenico Prisco
Management of ongoing direct anticoagulant treatment in patients with hip fracture
description Abstract Aim of the present study was to investigate the effects of ongoing treatment with DOACs on time from trauma to surgery and on in-hospital clinical outcomes (blood losses, need for transfusion, mortality) in patients with hip fracture. Moreover we evaluated the adherence to current guidelines regarding the time from last drug intake and surgery. In this observational retrospective study clinical records of patients admitted for hip fracture from January 2016 to January 2019 were reviewed. 74 patients were in treatment with DOACs at hospital admission. Demographic data, comorbidities and functional status before trauma were retrieved. As control group we evaluated 206 patients not on anticoagulants matched for age, gender, type of fracture and ASA score. Time to surgery was significantly longer in patients treated with DOACs (3.6 + 2.7 vs. 2.15 ± 1.07 days, p < 0.0001) and treatment within 48 h was 47% vs. 80% in control group (p < 0.0001). The adherence to guidelines’ suggested time from last drug intake to surgery was 46%. Neither anticipation nor delay in surgery did result in increased mortality, length of stay or complication rates with the exception of larger perioperative blood loss (Hb levels < 8 g/dl) in DOACs patients (34% vs 9% p < 0.0001). Present results suggest that time to surgery is significantly longer in DOAC patients in comparison to controls and adherence to guidelines still limited.
format article
author Carlo Rostagno
Alessandro Cartei
Gianluca Polidori
Roberto Civinini
Alice Ceccofiglio
Gaia Rubbieri
Massimo Curcio
Alberto Boccaccini
Adriano Peris
Domenico Prisco
author_facet Carlo Rostagno
Alessandro Cartei
Gianluca Polidori
Roberto Civinini
Alice Ceccofiglio
Gaia Rubbieri
Massimo Curcio
Alberto Boccaccini
Adriano Peris
Domenico Prisco
author_sort Carlo Rostagno
title Management of ongoing direct anticoagulant treatment in patients with hip fracture
title_short Management of ongoing direct anticoagulant treatment in patients with hip fracture
title_full Management of ongoing direct anticoagulant treatment in patients with hip fracture
title_fullStr Management of ongoing direct anticoagulant treatment in patients with hip fracture
title_full_unstemmed Management of ongoing direct anticoagulant treatment in patients with hip fracture
title_sort management of ongoing direct anticoagulant treatment in patients with hip fracture
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/af64a737e4464649a285bdd76e81aec5
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