Early Hip Fracture Surgery Safe in Patients on DOACs - Summary - MDSpire

Early Hip Fracture Surgery Safe in Patients on DOACs

Multicenter cohort findings indicate that early surgery in patients on direct oral anticoagulants was associated with shorter hospitalization without increased bleeding.

  • By

  • Julie Greenbaum

  • February 27, 2026

  • 4 min

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Objective:

To evaluate the safety and outcomes of early hip fracture surgery in patients taking direct oral anticoagulants (DOACs).

Key Findings:
  • Median hemoglobin decrease was 0.6 mmol/L in early surgery vs 0.9 mmol/L in delayed surgery.
  • Early surgery was associated with a 0.25 mmol/L lower hemoglobin decrease compared to delayed surgery.
  • No significant differences in blood transfusions or postoperative anemia between the two groups.
  • Early surgery resulted in a shorter median hospital stay (6 days vs 8 days).
  • In-hospital mortality was 1% for early surgery vs 2% for delayed surgery; 30-day mortality was 3% vs 5%.
Interpretation:

Early surgery in patients on DOACs does not lead to greater hemoglobin decrease and is linked to shorter hospital stays, indicating its safety.

Limitations:
  • Retrospective design may introduce bias.
  • Lack of data on timing of last DOAC dose and serum levels.
  • Missing data on comorbidities, fracture type, and functional status.
Conclusion:

Surgery within 24 hours for hip fracture patients on DOACs is safe and does not increase the risk of significant hemoglobin decrease.

Original Source(s)

Early Hip Fracture Surgery Safe in Patients on DOACs

  • by Julie Greenbaum

  • February 27, 2026

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