A working group of the Fragility Fracture Network Hip Fracture Audit Special Interest Group has developed recommendations on the management of hip fracture patients who are taking direct oral anticoagulants. The treatment of these patients is inconsistent around the world related to concerns about complications.
Following a review of the literature and a consensus process the following four consensus statements were achieved:
- peripheral nerve blocks can reasonably be performed on presentation for patients with hip fracture who are receiving direct oral anticoagulants;
- hip fracture surgery can reasonably be performed for patients taking direct oral anticoagulants < 36 h from last dose;
- general anaesthesia could reasonably be administered for patients with hip fracture and who are taking direct oral anticoagulants < 36 h from last dose (assuming eGFR > 60 ml.min-1.1.73 m-2); and
- it is generally reasonable to consider recommencing direct oral anticoagulants (considering blood loss and haemoglobin) < 48 h after hip fracture surgery.
These statements will help clinicians make the decision on timely management for this vulnerable patient population.
Click here for the infographic with the consensus statements.
Click here for the article.
