Effects of heparin bridging anticoagulation on perioperative bleeding and thromboembolic risks in patients undergoing abdominal malignancy surgery
Recent publications provided controversial results indicating that perioperative heparin bridging anticoagulation (HBA) increased the bleeding risk without decreasing the thromboembolic risk in patients undergoing minor surgery. To investigate if this is also the case in high-risk patients undergoin...
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| Veröffentlicht in: | Journal of anesthesia 2016-08, Vol.30 (4), p.723-726 |
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| creator | Ono, Kazumi Hidaka, Hidekuni Koyama, Yusuke Ishii, Kenzo Taguchi, Shinya Kosaka, Mako Okazaki, Nobuki Tanimoto, Wakana Katayama, Akira |
| description | Recent publications provided controversial results indicating that perioperative heparin bridging anticoagulation (HBA) increased the bleeding risk without decreasing the thromboembolic risk in patients undergoing minor surgery. To investigate if this is also the case in high-risk patients undergoing major abdominal malignancy surgery, we retrospectively collected data of 3268 patients over a 10-year period. After the interruption of preoperative antithrombotic agents, HBA was initiated with a prophylactic-dose of unfractionated heparin in 133 patients (HBA group), and 62 patients did not receive HBA (non-HBA group). The incidence of exogenous blood transfusion (EBT) and thromboembolic events (TEEs) within 30 days after surgery were compared between the HBA and non-HBA groups. The results showed that the incidence of EBT and TEEs was similar between the two groups (23.3 vs 19.4 %;
P
= 0.535) and (4.1 vs 3.2 %;
P
= 0.821), respectively. The amount of intraoperative bleeding and the length of postoperative hospital stay were also similar [median (quantile 1−3); 192 (71–498) vs 228 ml (100–685);
P
= 0.422] and [12 (9–19) vs 14.5 days (10–21);
P
= 0.052], respectively. These findings may suggest it is unlikely that prophylactic-dose HBA affects bleeding and thromboembolic risks in patients undergoing major abdominal malignancy surgery. |
| doi_str_mv | 10.1007/s00540-016-2187-0 |
| format | Article |
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P
= 0.535) and (4.1 vs 3.2 %;
P
= 0.821), respectively. The amount of intraoperative bleeding and the length of postoperative hospital stay were also similar [median (quantile 1−3); 192 (71–498) vs 228 ml (100–685);
P
= 0.422] and [12 (9–19) vs 14.5 days (10–21);
P
= 0.052], respectively. These findings may suggest it is unlikely that prophylactic-dose HBA affects bleeding and thromboembolic risks in patients undergoing major abdominal malignancy surgery.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-016-2187-0</identifier><identifier>PMID: 27206420</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Aged, 80 and over ; Anesthesiology ; Anticoagulants ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Blood Transfusion ; Clinical Report ; Complications and side effects ; Critical Care Medicine ; Development and progression ; Dosage and administration ; Emergency Medicine ; Female ; Hemorrhage - epidemiology ; Heparin ; Heparin - administration & dosage ; Heparin - adverse effects ; Humans ; Incidence ; Intensive ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasms - surgery ; Pain Medicine ; Postoperative Period ; Retrospective Studies ; Risk ; Risk factors ; Thromboembolism ; Thromboembolism - prevention & control</subject><ispartof>Journal of anesthesia, 2016-08, Vol.30 (4), p.723-726</ispartof><rights>Japanese Society of Anesthesiologists 2016</rights><rights>COPYRIGHT 2016 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-8665db69c0a74a4b5e6124865363580e7501bf1bde5bc69bd970452d7715936b3</citedby><cites>FETCH-LOGICAL-c473t-8665db69c0a74a4b5e6124865363580e7501bf1bde5bc69bd970452d7715936b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-016-2187-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-016-2187-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27206420$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ono, Kazumi</creatorcontrib><creatorcontrib>Hidaka, Hidekuni</creatorcontrib><creatorcontrib>Koyama, Yusuke</creatorcontrib><creatorcontrib>Ishii, Kenzo</creatorcontrib><creatorcontrib>Taguchi, Shinya</creatorcontrib><creatorcontrib>Kosaka, Mako</creatorcontrib><creatorcontrib>Okazaki, Nobuki</creatorcontrib><creatorcontrib>Tanimoto, Wakana</creatorcontrib><creatorcontrib>Katayama, Akira</creatorcontrib><title>Effects of heparin bridging anticoagulation on perioperative bleeding and thromboembolic risks in patients undergoing abdominal malignancy surgery</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Recent publications provided controversial results indicating that perioperative heparin bridging anticoagulation (HBA) increased the bleeding risk without decreasing the thromboembolic risk in patients undergoing minor surgery. To investigate if this is also the case in high-risk patients undergoing major abdominal malignancy surgery, we retrospectively collected data of 3268 patients over a 10-year period. After the interruption of preoperative antithrombotic agents, HBA was initiated with a prophylactic-dose of unfractionated heparin in 133 patients (HBA group), and 62 patients did not receive HBA (non-HBA group). The incidence of exogenous blood transfusion (EBT) and thromboembolic events (TEEs) within 30 days after surgery were compared between the HBA and non-HBA groups. The results showed that the incidence of EBT and TEEs was similar between the two groups (23.3 vs 19.4 %;
P
= 0.535) and (4.1 vs 3.2 %;
P
= 0.821), respectively. The amount of intraoperative bleeding and the length of postoperative hospital stay were also similar [median (quantile 1−3); 192 (71–498) vs 228 ml (100–685);
P
= 0.422] and [12 (9–19) vs 14.5 days (10–21);
P
= 0.052], respectively. These findings may suggest it is unlikely that prophylactic-dose HBA affects bleeding and thromboembolic risks in patients undergoing major abdominal malignancy surgery.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesiology</subject><subject>Anticoagulants</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Blood Transfusion</subject><subject>Clinical Report</subject><subject>Complications and side effects</subject><subject>Critical Care Medicine</subject><subject>Development and progression</subject><subject>Dosage and administration</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Hemorrhage - epidemiology</subject><subject>Heparin</subject><subject>Heparin - administration & dosage</subject><subject>Heparin - adverse effects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intensive</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasms - surgery</subject><subject>Pain Medicine</subject><subject>Postoperative Period</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Thromboembolism</subject><subject>Thromboembolism - prevention & control</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQxiMEotvCA3BBlrhwSRnHsZMcq6pApUpc4GzZ8SR1SezFTpD2NfrEzJKChLRC_ieNf99YnvmK4g2HSw7QfMgAsoYSuCor3jYlPCt2vBZt2QrZPS920HFRtkq1Z8V5zg8AoDgXL4uzqqlA1RXsisebYcB-ySwO7B73JvnAbPJu9GFkJiy-j2ZcJ7P4GBjNPSYfaaPAT2R2QnQb6dhyn-JsI9KafM-Sz98zo3R7YjHQE2twmMb4m7cuzj6Yic1m8mMwoT-wvKYR0-FV8WIwU8bXT-dF8e3jzdfrz-Xdl0-311d3ZV83Yjn-Szqruh5MU5vaSlS8qlslhRKyBWwkcDtw61DaXnXWdQ3UsnJNw2UnlBUXxfst7z7FHyvmRc8-9zhNJmBcs-Yt1agmVhL6bkNHM6H2YYhLMv0R11d1A5LzVgiiyhPUiIHKNcWAg6fwP_zlCZ6Gw5nqfkrAN0GfYs4JB71PfjbpoDnooyP05ghNjtBHR2ggzdunX652RvdX8ccCBFQbkOkqUAP0Q1wTtSb_J-svx5DB6w</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Ono, Kazumi</creator><creator>Hidaka, Hidekuni</creator><creator>Koyama, Yusuke</creator><creator>Ishii, Kenzo</creator><creator>Taguchi, Shinya</creator><creator>Kosaka, Mako</creator><creator>Okazaki, Nobuki</creator><creator>Tanimoto, Wakana</creator><creator>Katayama, Akira</creator><general>Springer Japan</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160801</creationdate><title>Effects of heparin bridging anticoagulation on perioperative bleeding and thromboembolic risks in patients undergoing abdominal malignancy surgery</title><author>Ono, Kazumi ; Hidaka, Hidekuni ; Koyama, Yusuke ; Ishii, Kenzo ; Taguchi, Shinya ; Kosaka, Mako ; Okazaki, Nobuki ; Tanimoto, Wakana ; Katayama, Akira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-8665db69c0a74a4b5e6124865363580e7501bf1bde5bc69bd970452d7715936b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesiology</topic><topic>Anticoagulants</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Blood Transfusion</topic><topic>Clinical Report</topic><topic>Complications and side effects</topic><topic>Critical Care Medicine</topic><topic>Development and progression</topic><topic>Dosage and administration</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Hemorrhage - epidemiology</topic><topic>Heparin</topic><topic>Heparin - administration & dosage</topic><topic>Heparin - adverse effects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intensive</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasms - surgery</topic><topic>Pain Medicine</topic><topic>Postoperative Period</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk factors</topic><topic>Thromboembolism</topic><topic>Thromboembolism - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ono, Kazumi</creatorcontrib><creatorcontrib>Hidaka, Hidekuni</creatorcontrib><creatorcontrib>Koyama, Yusuke</creatorcontrib><creatorcontrib>Ishii, Kenzo</creatorcontrib><creatorcontrib>Taguchi, Shinya</creatorcontrib><creatorcontrib>Kosaka, Mako</creatorcontrib><creatorcontrib>Okazaki, Nobuki</creatorcontrib><creatorcontrib>Tanimoto, Wakana</creatorcontrib><creatorcontrib>Katayama, Akira</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ono, Kazumi</au><au>Hidaka, Hidekuni</au><au>Koyama, Yusuke</au><au>Ishii, Kenzo</au><au>Taguchi, Shinya</au><au>Kosaka, Mako</au><au>Okazaki, Nobuki</au><au>Tanimoto, Wakana</au><au>Katayama, Akira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of heparin bridging anticoagulation on perioperative bleeding and thromboembolic risks in patients undergoing abdominal malignancy surgery</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>30</volume><issue>4</issue><spage>723</spage><epage>726</epage><pages>723-726</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Recent publications provided controversial results indicating that perioperative heparin bridging anticoagulation (HBA) increased the bleeding risk without decreasing the thromboembolic risk in patients undergoing minor surgery. To investigate if this is also the case in high-risk patients undergoing major abdominal malignancy surgery, we retrospectively collected data of 3268 patients over a 10-year period. After the interruption of preoperative antithrombotic agents, HBA was initiated with a prophylactic-dose of unfractionated heparin in 133 patients (HBA group), and 62 patients did not receive HBA (non-HBA group). The incidence of exogenous blood transfusion (EBT) and thromboembolic events (TEEs) within 30 days after surgery were compared between the HBA and non-HBA groups. The results showed that the incidence of EBT and TEEs was similar between the two groups (23.3 vs 19.4 %;
P
= 0.535) and (4.1 vs 3.2 %;
P
= 0.821), respectively. The amount of intraoperative bleeding and the length of postoperative hospital stay were also similar [median (quantile 1−3); 192 (71–498) vs 228 ml (100–685);
P
= 0.422] and [12 (9–19) vs 14.5 days (10–21);
P
= 0.052], respectively. These findings may suggest it is unlikely that prophylactic-dose HBA affects bleeding and thromboembolic risks in patients undergoing major abdominal malignancy surgery.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>27206420</pmid><doi>10.1007/s00540-016-2187-0</doi><tpages>4</tpages></addata></record> |
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| identifier | ISSN: 0913-8668 |
| ispartof | Journal of anesthesia, 2016-08, Vol.30 (4), p.723-726 |
| issn | 0913-8668 1438-8359 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Aged Aged, 80 and over Anesthesiology Anticoagulants Anticoagulants - administration & dosage Anticoagulants - adverse effects Blood Transfusion Clinical Report Complications and side effects Critical Care Medicine Development and progression Dosage and administration Emergency Medicine Female Hemorrhage - epidemiology Heparin Heparin - administration & dosage Heparin - adverse effects Humans Incidence Intensive Male Medicine Medicine & Public Health Middle Aged Neoplasms - surgery Pain Medicine Postoperative Period Retrospective Studies Risk Risk factors Thromboembolism Thromboembolism - prevention & control |
| title | Effects of heparin bridging anticoagulation on perioperative bleeding and thromboembolic risks in patients undergoing abdominal malignancy surgery |
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