Table 1.
Baseline characteristics of the included studies of this study.
| Included studies | Country |
Study design |
Number of participants |
Age (y) /Male (%) |
Study period |
Data source |
DOACs | Follow-up in DOAC users (months) | Controls | Outcomes |
Quality assessment* |
|---|---|---|---|---|---|---|---|---|---|---|---|
| He-2020 | Québec Canada | Observational study | 25,663 | 75.6/50.3 | 2000–2014 | Québec healthcare databases | DA; RIV; API | NA | VKAs | Any fracure,hip fracture, upper extremity fracture, vertebral fracture, Osteoporosis with pathological fracture |
8 |
| Lau-2020 | Hong Kong China | Observational study | 23,515 | 74.4/52.0 | 2010–2017 | Clinical data analysis and reporting system | DA; RIV; API | 14.1 | warfarin | Osteoporotic fracture | 8 |
| Huang-2020 | Taiwan China | Observational study | 19,414 | 71.9/59.0 | 2012–2017 | Taiwan's national health insurance research database | DA; RIV; API | 28.8 | warfarin | Hip, vertebral, and humerus/forearm/wrist fractures | 8 |
| Binding-2019 | Danish | Observational study | 37,350 | NA/57.8 | 2013–2017 | Danish national patient register | DOACs | 24.0 | warfarin | any fracture, major osteoporotic fractures, initiating osteoporotic medication, hip fractures |
8 |
| Lutsey-2019 | United States | Observational study | 167,275 | 68.9/62 | 2010–2015 | MarketScan commercial claims and encounters and marketscan Medicare Supplemental and Coordination of Benefitsdatabases | DA; RIV; API | 16.9 | warfarin | Hip fractures, Inpatient fractures, All fractures | 8 |
| Chan YH-2019 | Taiwan China | Observational study | 24,338 | 74.6/56.8 | 2012–2017 | National health insurance research database | EDO | >12.0 | warfarin | Any fracture | 8 |
| Norby-2017 | United States | Observational study | 77,991 | 70.3/60.5 | 2010–2014 | The truven health marketscan® commercial claims and encounters database and the medicare supplemental and coordination of benefits database |
RIV | 12.0 | warfarin | Hip/pelvic fracture | 8 |
| Lucenteforte-2017 | Denmark | Observational study | 16,850 | NA/51.1 | 2009–2015 | Danish national prescription registry | DA | 12.6 | warfarin | Any fracture | 8 |
| Bengtson-2017 | United States | Observational study | 61,648 | 70.1/63.3 | 2009–2012 | The truven health marketscan® commercial claims and encounters database and the medicare supplemental and coordination of benefits database |
DA | 15.0 | warfarin | Hip/pelvic fracture | 8 |
| Steffel-2016 | United States | Post-hoc analysis | 20,205 | 72.0/62.4 | NA | ENGAGE AF-TIMI 48 trial | EDO | NA | warfarin | Any fracture | Low risk |
ENGAGE AF-TIMI 48, effective anticoagulation with factor xa next generation in atrial fibrillation-thrombolysis in myocardial infarction 48; DOACs, direct oral anticoagulants; DA, dabigatran; RIV, rivaroxaban; API, apixaban; EDO, edoxaban; VKAs, vitamin K antagonists; NOS, newcastle-ottawa scale; NA, not available.
*
The Newcastle-Ottawa Scale (NOS) items were used to evaluate the quality of the observational studies, which involve the selection of cohorts, the comparability of cohorts, and the assessment of the outcome).