Schuetze K, et al. - In this study, for the first time, patients on anticoagulant medication with proximal femur fractures that were operated within 24 hours were investigated. Researchers retrospectively reviewed data of 327 patients (mean age 80 ± 13 years; 223 women and 104 men) with sub- or intertrochanteric fractures and included patients without or with only one type of oral anticoagulation. They identified 74 patients who were undergoing treatment with aspirin, 30 with platelet aggregation inhibitors, 52 with direct oral anticoagulants (DOAC) and 25 with vitamin-K-antagonists (VKA) medication. Prior to surgery, high dose Vitamin K or coagulation factors were administered to all patients taking VKA to normalize INR. They observed a 3.4-fold increased risk for intraoperative blood transfusion among patients undergoing treatment with DOAC. Outcomes support the safety of early surgical care of proximal femur fractures even in patients with anticoagulant medication. Preoperative preparation of all patients, especially patients on DOAC, for possibly intraoperative transfusion is recommended.