Risk-adjusted perioperative bridging anticoagulation reduces bleeding complications without increasing thromboembolic events in general and visceral surgery

Autor: Ida Döhler, Daniel Röder, Tobias Schlesinger, Christian Alexander Nassen, Christoph-Thomas Germer, Armin Wiegering, Johan Friso Lock
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Anesthesiology, Vol 23, Iss 1, Pp 1-8 (2023)
Druh dokumentu: article
ISSN: 1471-2253
DOI: 10.1186/s12871-023-02017-z
Popis: Abstract Background Perioperative bridging of oral anticoagulation increases the risk of bleeding complications after elective general and visceral surgery. The aim of this study was to explore, whether an individual risk-adjusted bridging regimen can reduce bleeding events, while still protecting against thromboembolic events. Methods We performed a quality improvement study comparing bridging parameters and postoperative outcomes before (period 1) and after implementation (period 2) of a new risk-adjusted bridging regimen. The primary endpoint of the study was overall incidence of postoperative bleeding complications during 30 days postoperatively. Secondary endpoints were major postoperative bleeding, minor bleeding, thromboembolic events, postoperative red blood cell transfusion, perioperative length-of-stay (LOS) and in-hospital mortality. Results A total of 263 patients during period 1 and 271 patients during period 2 were compared. The included elective operations covered the entire field of general and visceral surgery. The overall incidence of bleeding complications declined from 22.1% during period 1 to 10.3% in period 2 (p
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