Perioperative antithrombotic medication use in non-cardiac surgery:a single center survey
10.3969/j.issn.1004-8812.2025.04.001
- VernacularTitle:非心脏外科手术患者围术期抗血栓药物使用单中心调查
- Author:
Bin-bin DONG
1
;
Yu-tong ZHAO
;
Zi-ning WANG
;
Huai-jin LI
;
Shan ZHU
;
Hong ZHANG
;
Yan-jun GONG
;
Jie JIANG
Author Information
1. 北京大学第一医院心血管内科,北京 100034
- Publication Type:Journal Article
- Keywords:
Antithrombotic drugs;
Perioperative strategy;
Bridging therapy;
Non-cardiac surgery
- From:
Chinese Journal of Interventional Cardiology
2025;33(4):181-188
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the perioperative management of antithrombotic drugs in patients undergoing non-cardiac surgery.Methods Patients on long-term antithrombotic drugs who underwent non-cardiac surgery in our hospital were included.Through interviews with patients and physicians,perioperative antithrombotic medication regimens were reviewed and compared with the"Multidisciplinary Expert Consensus on Perioperative Management of Antithrombotic Therapy"to evaluate compliance with consensus and analyze influencing factors.Results A total of 372 patients were included in the analysis.Among them,355 patients were on long-term antiplatelet therapy alone,and 17 were on long-term oral anticoagulantion.364(97.8％)discontinued antithrombotic medications prior to surgery.109 patients(29.3％)received low molecular weight heparin(LMWH)bridging therapy.Among the 355 patients on antiplatelet therapy,108(30.4％)had discontinuation durations consistent with the consensus recommendations,while 186(52.4％)discontinued medications for longer periods.Postoperatively,the average hospital stay for antiplatelet therapy patients was 6.64 days,with only 37(10.4％)resuming therapy during hospitalization.The average hospital stay for patients on anticoagulants was 9.94 days,with only 2(11.8％)resuming therapy during hospitalization.Regarding perioperative risk assessment,only 40(10.8％)of patients underwent additional internal medical evaluation for thromboembolic risk after medication discontinuation,with the remainder assessed soly by surgeons.Coronary heart disease was an independent risk factor associated with internal medical evaluation(OR 2.851,95％CI 1.160-7.011,P=0.022).For bleeding risk assessment,surgeons evaluations aligned with the consensus in 68.0％of cases,but surgeons tended to underestimate risk compared to the consensus.Conclusions In this single-center study,perioperative antithrombotic management showed low compliance with expert consensus,characterized by prolonged preoperative medication discontinuation,high rates of LMWH bridging,and low postoperative in-hospital resumption of therapy.A robust multidisciplinary collaboration system should be established to enhance comprehensive patient assessment.
