Impact of Early (<24 Hours) vs. Delayed (≥24 Hours) Surgery on Hemoglobin Decrease in Patients With Hip Fracture on Direct Oral Anticoagulants

JBJS Open Access 2026 Open access

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Authors: T.E.E. Schiepers, H.C. Willems, Dpj Smeeing, E. Bosma, D.H.R. Kempen, M.H. Emmelot-Vonk, D. van der Velde, H.J. Schuijt, the OPTIMIZE-DOAC Study Group
DOI: 10.2106/jbjs.oa.25.00334
Cited by: 2
References: 47

Abstract

Background: Surgery in patients with hip fracture on direct oral anticoagulants (DOACs) is frequently delayed because of concerns about bleeding risk. However, evidence supporting such delays remains limited, and institutional practices vary widely. This study aims to determine whether early surgery within 24 hours is associated with a greater perioperative hemoglobin decrease compared with delayed surgery after 24 hours or more in patients with hip fracture on DOACs. Methods: This multicenter retrospective cohort study included patients with hip fracture aged ≥70 years on DOACs at admission across 5 hospitals from 2018 to 2023. Patients were stratified by time to surgery:

Fields of Study & Subjects

Hip and Femur Fractures Cardiac Anesthesia and Surgical Outcomes Trauma Hemostasis Coagulopathy Resuscitation

Publication details

Journal / source
JBJS Open Access
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
11
Issue
1
Publication date
1 January 2026
Language
EN