Emerging Barrier to Timely Care of Hip Fracture Patients: A Prospective Study of Direct Oral Anticoagulation and Time to Surgery
Bibliographic record
Abstract
Rapid surgical management of hip fracture patients is critical to reduce morbidity and mortality. These patients may be anticoagulated and the new direct oral anticoagulants (DOAC) may introduce delays to treatment. Our purpose was to examine the impact of these DOAC on time to surgical management for hip fracture patients. Methods A prospective audit of 55 consecutive operative hip fracture patients examined time from diagnosis to surgery. Indications for anticoagulation were recorded. Results Time to surgery for the DOAC group was 66±16 hours, versus 38±21 and 25±19 hours for warfarin and control groups, respectively (P<0.05). Anticoagulation was for atrial fibrillation in 93%. Conclusion Patients on DOAC faced significant delays to surgery. Given that both DOAC use and incidence of hip fracture are expected to rise, this presents a barrier to optimized care in this vulnerable group.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".