Association between preoperative use of antithrombotic medications and intraoperative transfusion in older patients undergoing cancer surgery
- 주제(키워드) Comprehensive geriatric assessment , Intraoperative transfusion , Antithrombotics , Surgical oncology patients , Long-acting anticoagulants
- 주제(기타) Surgery
- 설명문(일반) [Jeong, Young Mi; Choi, Kyung Suk; Jeon, Min Sun; Yee, Jeong; Lee, Byung Koo; Gwak, Hye Sun] Ewha Womans Univ, Coll Pharm, 52 Ewhayeodae Gil, Seoul 03760, South Korea; [Jeong, Young Mi; Choi, Kyung Suk; Jeon, Min Sun; Yee, Jeong; Lee, Byung Koo; Gwak, Hye Sun] Ewha Womans Univ, Div Life Pharmaceut Sci, 52 Ewhayeodae Gil, Seoul 03760, South Korea; [Jeong, Young Mi; Choi, Kyung Suk; Jeon, Min Sun; Lee, Eunsook] Seoul Natl Univ, Dept Pharm, Bundang Hosp, Seongnam 13620, South Korea; [Chung, Jee Eun] Hanyang Univ, Coll Pharm, Ansan 15588, South Korea; [Kwang-Il Kim] Seoul Natl Univ, Coll Med, Dept Internal Med, Bundang Hosp, Seongnam 13620, South Korea
- 등재 SCIE, SCOPUS
- OA유형 gold
- 발행기관 ELSEVIER SINGAPORE PTE LTD
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000168897
- 본문언어 영어
- Published As https://dx.doi.org/10.1016/j.asjsur.2019.06.005
- PubMed https://pubmed.ncbi.nlm.nih.gov/31253383
초록/요약
Background: Management of antiplatelet agents and other chronic anticoagulation medications in patients scheduled for surgery can reduce intraoperative bleeding complications. However, few studies on the association of antithrombotics, relative to their duration of action, with intraoperative transfusion have been conducted. We aimed to determine the association of recent use of antithrombotics, relative to their duration of action, with intraoperative transfusion in elderly people undergoing cancer surgery. Methods: The study subjects were patients aged 65 years or older who were scheduled for cancer surgery and presented for comprehensive geriatric assessment. We reviewed the baseline patient characteristics obtained from electronic medical records and the patients' preoperative medication history, including anticoagulants, antiplatelet agents, and streptokinase/ streptodornase. Results: A total of 475 cancer patients were included. Multivariate analysis showed that longacting anticoagulant therapy before surgery was a significant risk factor for intraoperative transfusion. Long-acting anticoagulants increased the risk of transfusion approximately 15.9-fold (95% CI 1.9-136.2). The attributable risk of long-acting anticoagulants to transfusion was approximately 93.7%. Also, low body mass index (BMI) and hepato-pancreato-biliary (HPB) surgery were significantly associated with intraoperative transfusion. The adjusted odds ratios for low BMI (<18.5 kg/m(2)) and HPB surgery (reference: lower gastrointestinal surgery) were 5.3 (95% CI 1.8-15.4) and 4.9 (95% CI 1.9-12.5), respectively. Conclusions: It was found that the perioperative use of long-acting anticoagulants was associated with an increased risk of intraoperative transfusion, further highlighting the importance of medication optimization for elderly patients with cancer surgery. (C) 2019 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.
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