Hip Fracture Surgery Timing and Blood Transfusion Risk in Patients on DOACs
Blood Transfusion Risk After Early vs. Delayed Surgery in Hip Fracture Patients on Direct Oral Anticoagulants: A Natural Experiment
St. Antonius Hospital
374 participants
Nov 1, 2025
OBSERVATIONAL
Summary
This study looks at patients with hip fractures who are taking direct oral anticoagulants (DOACs), a type of blood thinner. In many hospitals, surgery for these patients is delayed because of concerns about bleeding, but waiting longer can also increase risks such as complications and longer hospital stays. The purpose of this study is to find out whether operating within 24 hours is as safe as delaying surgery beyond 24 hours. Specifically, the investigators want to know if early surgery does not lead to a higher need for blood transfusions compared to delayed surgery.
Eligibility
Inclusion Criteria2
- Isolated hip fracture classified as AO/OTA 31A or 31B requiring surgical intervention.
- Current DOAC use with the last dose taken ≤24 hours before emergency department (ED) presentation
Exclusion Criteria5
- Pathologic or periprosthetic hip fractures.
- Fracture sustained >24 hours before ED presentation.
- Inter-hospital transfer.
- Hematologic disorders (e.g., thalassemia, sickle cell disease, aplastic anemia, myelodysplastic syndromes, leukemia).
- Use of a non-EMA-approved DOAC (e.g., betrixaban).
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Locations(7)
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NCT07309848