RESUMO
Introduction Delayed surgical management of hip fractures increases mortality. The Irish and UK guidelines recommend surgery within 48 hours of presentation.1-3 Our study aimed to evaluate the prevalence of hip fracture surgery delays secondary to anticoagulation, while also documenting anaesthesia preferences, rates of appropriate dosing as well as rates of venous thromboembolism, bleeding events and cerebrovascular accidents. Methods Single centre retrospective analysis of hip fracture patients admitted during a one-year period. Results In the year 2022, 48 out of 251 (19.1%) hip fracture surgeries were delayed beyond 48-hours. Notably, 26 (54.1%) of these patients were on a DOAC. In 23 (88.5%) cases, anticoagulation was the sole cause of delay. Only 9 (39.1%) of these delayed cases were documented by anaesthetics. Of patients who experienced delays on anticoagulation, patient weights were documented in 7/22 (31.8%) of cases, hindering dosing review. Of documented weights, 9/22 (41%) were receiving the wrong dose anticoagulant. Only 4/22 (18%) of those delayed due to anticoagulation had an acute kidney injury on admission. 7/22 (31.8%) of delayed patients due to anticoagulation received general anaesthetic while, 15/22 (68.1%) received spinal anaesthetic. No major bleeding, or clotting events were reported six months post-operatively. Patients aged over 80 years accounted for 15/22 (69.5%) of those delayed due to a DOAC. Our study revealed that 23 out of 48 (47.9%) of the hip fracture surgical delays in our centre in the year 2022 were associated with patients taking DOACs on admission. We advocate for the elimination of these delays in alignment with the latest best evidence.