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Oral anticoagulants, warfarin yielded similar bleeding, transfusion rates for hip fractures
Although patients with hip fractures on direct oral anticoagulants experienced long elapse time until surgical repair, results showed no differences in bleeding or transfusion rates when compared with patients on warfarin.
Researchers performed a retrospective analysis of data on 320 patients who were 65 years of age or older with isolated hip fractures. Researchers categorized patients into groups based on whether they did not receive any antithrombotic therapy (n=207), were on warfarin (Coumadin, Bristol-Myers Squibb U.S.; n=59) or were on direct oral anticoagulants (n=54). Main outcome measures included time to surgery, blood loss, mortality, hospital length of stay, red blood cell transfusion, use of reversal agents and Charlson Comorbidity Index (CCI).
Compared with patients who did not receive any antithrombotic therapy, results showed a higher CCI among patients on warfarin or direct oral anticoagulants. Although significantly more patients in the warfarin group received reversal agents vs. the direct oral anticoagulant group, researchers found a similar percentage of patients received transfusion in both groups. Patients who did not receive any antithrombotic therapy had a significantly shorter time to surgery compared with patients on direct oral anticoagulants, according to results. Researchers noted no differences between groups in postoperative hemorrhage, ICU length of stay and mortality.
“Our study confirmed previous findings that patients on [direct oral anticoagulants] DOACs did not reveal higher bleeding rates or higher transfusion requirements compared with [Coumadin] COU. The longest elapse for surgical [hip fracture] HF repair was observed for DOAC patients. However, this had not influence on ICU length of stay,” the authors wrote. “We observed a trend toward lower mortality of patients on DOACs compared with COU. Larger studies with a sufficient number of patients are warranted to confirm these findings.” – by Casey Tingle
Disclosures: Bruckbauer reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.