Effect of preinjury use of direct oral anticoagulants vs. Vitamin K antagonists on outcomes of hip fracture: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#aged #anticoagulants #blood-transfusion #hip-fractures #humans

Effect of preinjury use of direct oral anticoagulants vs. Vitamin K antagonists on outcomes of hip fracture: a systematic review and meta-analysis

Gong et al., 2021 | Eur Rev Med Pharmacol Sci | Meta Analysis

Citation

Gong L-N, Li J-Y, ... Chu J. Effect of preinjury use of direct oral anticoagulants vs. Vitamin K antagonists on outcomes of hip fracture: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2021-Oct;25(20):6260-6270. doi:10.26355/eurrev_202110_26995

Abstract

OBJECTIVE: Elderly patients with hip fractures are frequently under anticoagulant therapy. We aimed to assess if outcomes of hip fracture patients undergoing surgical intervention differ with prior use of direct oral anticoagulants (DOAC) or Vitamin K antagonists (VKA). MATERIALS AND METHODS: PubMed, Embase, and Google Scholar were searched for comparative studies published up to June 20, 2021. Dichotomous variables were summarized using odds ratio (OR) and continuous variables using mean difference (MD). RESULTS: Fourteen studies were included. There was no difference in the time to surgery between patients on DOAC or VKA (MD: 2.50 95% CI -2.10, 7.10 I2=76% p=0.29). Number of undergoing surgeries within 48 hours was not significantly different between the two groups (OR: 0.77 95% CI 0.56, 1.06 I2=10% p=0.10). Mortality rates (OR: 0.84 95% CI 0.62, 1.14 I2=12% p=0.27), blood transfusion requirement (OR: 1.08 95% CI 0.80, 1.47 I2=30% p=0.62) and length of hospital stay (MD: 0.26 95% CI -0.70, 1.21 I2=0% p=0.60) was also not significantly different between patients on DOAC or VKA. CONCLUSIONS: There is no difference in surgical delay, early mortality, blood transfusion rates and length of hospital stay between DOAC uses and VKA users undergoing hip fracture surgery.

Key Findings

Fourteen studies were included. There was no difference in the time to surgery between patients on DOAC or VKA (MD: 2.50 95% CI -2.10, 7.10 I2=76% p=0.29). Number of undergoing surgeries within 48 hours was not significantly different between the two groups (OR: 0.77 95% CI 0.56, 1.06 I2=10% p=0.10). Mortality rates (OR: 0.84 95% CI 0.62, 1.14 I2=12% p=0.27), blood transfusion requirement (OR: 1.08 95% CI 0.80, 1.47 I2=30% p=0.62) and length of hospital stay (MD: 0.26 95% CI -0.70, 1.21 I2=0% p=

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population hip fractures are frequently
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Aged
  • Anticoagulants
  • Blood Transfusion
  • Hip Fractures
  • Humans
  • Length of Stay
  • Time Factors
  • Vitamin K

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Comparative Study, Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-k-bone

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09