Risk is not our business: safety of thoracic surgery in patients using antiplatelet therapy†
| Autor: | Sarah Palmisano, Andrea Viti, Giovanna Rizzardi, Luca Bertolaccini, Alberto Terzi, Giuseppe Coletta, Alberto Gorla |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Blood transfusion Time Factors medicine.medical_treatment Blood Loss Surgical Postoperative Hemorrhage Preoperative care Risk Assessment Institutional Reports Valve replacement Risk Factors medicine Humans Blood Transfusion Myocardial infarction Prospective Studies Prospective cohort study Propensity Score Aged Aged 80 and over Chi-Square Distribution business.industry Length of Stay Middle Aged Thoracic Surgical Procedures medicine.disease Surgery Logistic Models Treatment Outcome Italy Cardiothoracic surgery Case-Control Studies Propensity score matching Practice Guidelines as Topic Platelet aggregation inhibitor Drainage Female Patient Safety Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors |
| Popis: | American Heart Association recommendations have changed preoperative management of patients with antiplatelet therapy (APT). We assessed safety and outcomes of surgery in patients who were receiving APT. A prospective study of patients operated on while receiving APT was matched with those with no APT (ratio 1:4), using the propensity score method. Logistic regression analysis was used to identify covariates among imbalanced baseline patient variables. Both χ2 test and Fisher's test were used to calculate the probability value for the comparison of dichotomous variables. Between January 2008 and December 2010, 38 patients who received APT at the time of surgery were matched with 141 patients who had not received APT. APT indications were a history of myocardial infarction, coronary artery by-pass graft and/or valve replacement (19), coronary artery stent (11) and severe peripheral vascular disease (8). None of the patients required re-operation for bleeding. Two patients received blood transfusions. The amount of chest tube drainage was not statistically significantly different. There were no statistically significant differences between the outcomes for the operative time, length of hospital stay, estimated blood loss or morbidity. The results show that thoracic surgical procedures can safely be performed in patients receiving APT at the time of surgery, with no increased risk of bleeding or morbidity and no differences in the operative time and the length of hospital stay. |
| Databáze: | OpenAIRE |
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