Impact of direct oral anticoagulant treatment on management and outcomes of patients with hip fractures by monitoring assays. A population-based study of a cohort from the Geriatric Perioperative Unit
Abstract
Background: Hip fractures remain a challenge for patients on direct oral anticoagulants. In a population-based study, we wanted to evaluate the impact of DOACS and its concentration on postoperative mortality after hip fracture surgery. Methods: In a retrospective, monocenter study, we included all patients aged >65 yrs at a geriatric perioperative unit, admitted for hip fracture, treated with or without DOACs, and similarly managed with early surgery. Patients were divided into No-DOACs or DOACs groups. According to plasma DOAC concentrations on the day of surgery, DAOCs was divided into subgroup: <30, 3050, 5180 ng.mL1. Plasma of DOACs were analysed as long as the concentrations measured were >30 ng.mL1. The primary endpoint was mortality up to Day 30. Patient blood management and plasma assays were recorded. Results: From January 2022 to September 2023, 117 patients were analyzed in the DOACs group and 468 in the No-DOACs group. Patients with DOACs were most often operated on with a one-day delay (P < 0.05). Non DAOC group presented lower mortality at 30 day (P < 0.01). Up to Day 180, mortality rates were lower in the No-DOACs group with a 0.34 median hazard-risk [0.190.59]. Transfusion rates were similar in No-DOACs and DOACs groups (43 versus 48%, P = 0.55). Subgroups (<30, 3050, 50–80 ng.mL1) presented similar outcomes (transfusion, mortality). Conclusion: DOACs were associated with higher mortality. A level of up to < 80 ng.mL1 does not appear to make any difference to transfusion compared with no DOAC.
Related
- ASO Video Abstract: How to Deal with Median Arcuate Ligament during Pancreaticoduodenectomy? Management Strategies and Impact on Perioperative Outcomes
- Sensor-Based Monitoring Systems for Agricultural Water Management
- Application and evaluation of a quality indicator system for pharmaceutical care in orthopedic perioperative pain management
- Genomic diversity, population structure, and relatedness of critically endangered Philippine eagles under conservation management
- The wild honeybee population of Europe is in decline: Evidence from monitoring studies
BibTeX
@article{gricourt2026impact,
title = {{Impact of direct oral anticoagulant treatment on management and outcomes of patients with hip fractures by monitoring assays. A population-based study of a cohort from the Geriatric Perioperative Unit}},
author = {Yann Gricourt and Mikael Perin and Nicolas Basseres and Laetitia Geronimi and Jean-Yves Lefrant and Myriam Mezzarobba and Mathias Chéa and Jean Christophe Gris and Philippe Cuvillon},
journal = {Anaesthesia Critical Care \& Pain Medicine},
year = {2026},
month = oct,
doi = {10.1016/j.accpm.2025.101616},
url = {https://hal.science/hal-05829685v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of direct oral anticoagulant treatment on management and outcomes of patients with hip fractures by monitoring assays. A population-based study of a cohort from the Geriatric Perioperative Unit
AU - Yann Gricourt
AU - Mikael Perin
AU - Nicolas Basseres
AU - Laetitia Geronimi
AU - Jean-Yves Lefrant
AU - Myriam Mezzarobba
AU - Mathias Chéa
AU - Jean Christophe Gris
AU - Philippe Cuvillon
PY - 2026
DA - 2026/10/21
JO - Anaesthesia Critical Care & Pain Medicine
DO - 10.1016/j.accpm.2025.101616
UR - https://hal.science/hal-05829685v1
AB - Background: Hip fractures remain a challenge for patients on direct oral anticoagulants. In a population-based study, we wanted to evaluate the impact of DOACS and its concentration on postoperative mortality after hip fracture surgery. Methods: In a retrospective, monocenter study, we included all patients aged >65 yrs at a geriatric perioperative unit, admitted for hip fracture, treated with or without DOACs, and similarly managed with early surgery. Patients were divided into No-DOACs or DOACs groups. According to plasma DOAC concentrations on the day of surgery, DAOCs was divided into subgroup: <30, 3050, 5180 ng.mL1. Plasma of DOACs were analysed as long as the concentrations measured were >30 ng.mL1. The primary endpoint was mortality up to Day 30. Patient blood management and plasma assays were recorded. Results: From January 2022 to September 2023, 117 patients were analyzed in the DOACs group and 468 in the No-DOACs group. Patients with DOACs were most often operated on with a one-day delay (P < 0.05). Non DAOC group presented lower mortality at 30 day (P < 0.01). Up to Day 180, mortality rates were lower in the No-DOACs group with a 0.34 median hazard-risk [0.190.59]. Transfusion rates were similar in No-DOACs and DOACs groups (43 versus 48%, P = 0.55). Subgroups (<30, 3050, 50–80 ng.mL1) presented similar outcomes (transfusion, mortality). Conclusion: DOACs were associated with higher mortality. A level of up to < 80 ng.mL1 does not appear to make any difference to transfusion compared with no DOAC.
SN - 2352-5568
ER -