Department of Emergency Intensive Care Unit, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Zhejiang Province, China.
Eur Rev Med Pharmacol Sci. 2021 Oct;25(20):6260-6270. doi: 10.26355/eurrev_202110_26995.
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).
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).
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.
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.
髋部骨折的老年患者常接受抗凝治疗。我们旨在评估接受手术干预的髋部骨折患者在使用直接口服抗凝剂（DOAC）或维生素 K 拮抗剂（VKA）之前，其结局是否存在差异。
检索了截至 2021 年 6 月 20 日发表的比较研究，包括 PubMed、Embase 和 Google Scholar。二分类变量采用比值比（OR）进行总结，连续变量采用均数差（MD）进行总结。
共纳入 14 项研究。DOAC 组和 VKA 组患者的手术时间无差异（MD：2.50，95%CI-2.10，7.10，I2=76%，p=0.29）。两组在 48 小时内行手术的例数也无显著差异（OR：0.77，95%CI 0.56，1.06，I2=10%，p=0.10）。两组患者的死亡率（OR：0.84，95%CI 0.62，1.14，I2=12%，p=0.27）、输血需求（OR：1.08，95%CI 0.80，1.47，I2=30%，p=0.62）和住院时间（MD：0.26，95%CI-0.70，1.21，I2=0%，p=0.60）也无显著差异。
DOAC 使用者和 VKA 使用者行髋部骨折手术后，手术延迟、早期死亡率、输血率和住院时间无差异。
