지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
오류제보하기
Objective: The perioperative management of antithrombotic therapy is often challenging and it requires a fine balance between therisk of hemorrhage and thrombosis. We aimed to evaluate the antithrombotic management for moderate to high risk patients in realworld setting. Methods: Among the patients who were consulted to the neurologist for the evaluation of perioperative risk from 2010to 2012, patients undergoing moderate to high risk surgery and taking antithrombotics within 30 days were identified. We analyzedthe timing of discontinuation and reinitiation of antithrombotic drugs before or after surgery as well as the status of bridging therapy.
In addition, the conformity with the guideline suggested by American College of Chest Physicians was assessed. The rate ofthromboembolic event and major hemorrhage were also investigated. Results: A total of 329 patients were included. Theconcordance rate of warfarin stop and restart time with guideline was 23.4% and 10.3%, respectively. Continuing aspirin in patientsundergoing coronary artery bypass surgery or non-cardiac surgery in patients with high risk for cardiovascular events were 59.2%and 2.6%, respectively. Bridging therapy was adopted in 92.9% and 81.2% in patients who had received anticoagulant beforesurgery and who were at high and low risk thromboembolism, respectively. In entire cohorts, 30-day incidence of major bleedingand thromboembolic event were 31.9% and 3.0%. Co-morbid renal disease were shown as independent predictor for majorbleeding (adjusted OR 2.65. 95% CI 1.33-5.28). Conclusion: The concordance rate with guideline regarding perioperativeantithrombotic use was low and bridging therapy was prevalent in patients undergoing moderate to high risk surgery.
목차
등록된 정보가 없습니다.
참고문헌 (14)
참고문헌 신청
Blacker DJ / 2003 / Risk of ischemic stroke in patients with symptomatic vertebrobasilar stenosis undergoing surgical procedures / Stroke 34 (11) : 2659 ~ 2663
Broderick JP / 2011 / Withdrawal of antithrombotic agents and its impact on ischemic stroke occurrence / Stroke 42 (9) : 2509 ~ 2514
Bucerius J / 2003 / Stroke after cardiac surgery:a risk factor analysis of 16,184 consecutive adult patients / Ann Thorac Surg 75 (2) : 472 ~ 478
Dacey LJ / 2005 / Perioperative stroke and longterm survival after coronary bypass graft surgery / Ann Thorac Surg 79 (2) : 532 ~ 536
Douketis JD / 2012 / Perioperative Management of Antithrombotic Therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evi
Broderick JP / 2011 / Withdrawal of antithrombotic agents and its impact on ischemic stroke occurrence / Stroke 42 (9) : 2509 ~ 2514
Bucerius J / 2003 / Stroke after cardiac surgery:a risk factor analysis of 16,184 consecutive adult patients / Ann Thorac Surg 75 (2) : 472 ~ 478
Dacey LJ / 2005 / Perioperative stroke and longterm survival after coronary bypass graft surgery / Ann Thorac Surg 79 (2) : 532 ~ 536
Douketis JD / 2012 / Perioperative Management of Antithrombotic Therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evi
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