A 72-year-old woman with atrial fibrillation and a prior stroke presents with an acute displaced intertrochanteric hip fracture after a fall. She took...

Question

A 72-year-old woman with atrial fibrillation and a prior stroke presents with an acute displaced intertrochanteric hip fracture after a fall. She took her last dose of apixaban 12 hours ago. According to perioperative anticoagulation management principles, what is the most appropriate next step regarding surgery?

Accepted Answer

Proceed with hip fracture surgery within 24-48 hours, considering last dose timing and renal function, and using tranexamic acid and local haemostatic measures

Answer

Delay surgery for 5-7 days until apixaban is fully cleared

Answer

Administer vitamin K to reverse apixaban

Answer

Administer protamine sulphate to reverse apixaban

Answer

Cancel surgery because anticoagulation cannot be reversed

ca-mccqe1 MCQ (SBA): Perioperative DOAC management in hip fracture