Question

A 75-year-old woman is admitted following a fall and found to have a fractured neck of femur. She has a history of atrial fibrillation for which she takes apixaban 5mg BD. Her surgery is planned for tomorrow morning. According to guidance on perioperative management of anticoagulants, what is the most appropriate plan for her apixaban?

Accepted Answer

Omit the evening dose before surgery and the morning dose on the day of surgery

Answer

Continue apixaban as usual

Answer

Omit apixaban for 5 days before surgery

Answer

Reverse apixaban with Andexanet alfa immediately

Answer

Switch to low molecular weight heparin (LMWH) bridging

Practice question