Timing of hip fracture surgery for patients on DOAC blood thinners

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a multicenter observational cohort that uses variation in hospital practice across the Netherlands as a natural experiment to compare outcomes for patients having hip fracture surgery within 24 hours versus after 24 hours. Eligible patients have isolated AO/OTA 31A or 31B hip fractures and took an EMA-approved DOAC within 24 hours before emergency department presentation. The primary outcome is postoperative blood transfusion; secondary outcomes include perioperative hemoglobin change, infections, delirium, thromboembolic events, length of stay, and mortality. Because assignment to early or delayed surgery is based on routine hospital practice rather than randomization, the analysis will adjust for confounders across centers.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Isolated hip fracture classified as AO/OTA 31A or 31B requiring surgical intervention.
* Current DOAC use with the last dose taken ≤24 hours before emergency department (ED) presentation

Exclusion Criteria:

* Pathologic or periprosthetic hip fractures.
* Fracture sustained \>24 hours before ED presentation.
* Inter-hospital transfer.
* Hematologic disorders (e.g., thalassemia, sickle cell disease, aplastic anemia, myelodysplastic syndromes, leukemia).
* Use of a non-EMA-approved DOAC (e.g., betrixaban).

Where it's running

• Ziekenhuisgroep Twente Hospital
  Almelo, Netherlands Recruiting
• Onze Lieve Vrouw Gasthuis Hospital
  Amsterdam, Netherlands Recruiting
• Rijnstate Hospital
  Arnhem, Netherlands Recruiting
• Deventer Hospital
  Deventer, Netherlands Recruiting
• Martini Hospital
  Groningen, Netherlands Recruiting
• Diakonessenhuis Hospital
  Utrecht, Netherlands Recruiting

Study contacts

• Principal investigator: Henk Jan Schuijt, MD, PhD — Amsterdam University Medical Center
• Study coordinator: Tim Schiepers, MD
• Email: t.schiepers@antoniusziekenhuis.nl
• Phone: +31637557472

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.