Question

A 76-year-old with AF on apixaban requires urgent hip fracture surgery within 12 hours. Creatinine clearance 40 mL/min. What is most appropriate perioperative strategy?

Accepted Answer

Consider reversal with andexanet alfa or prothrombin complex concentrate if bleeding risk high

Answer

Stop apixaban; delay surgery 48-72 h

Answer

Proceed to surgery with neuraxial anaesthesia

Answer

Switch to warfarin pre-op

Answer

Give vitamin K

Practice question

A 76-year-old with AF on apixaban requires urgent hip fracture surgery within 12 hours. Creatinine clearance 40 mL/min. What is most appropriate perioperative strategy?