American journal of surgery · 2024
Effect of antiplatelet and anticoagulant therapy on bleeding complications following ventral hernia repair: An ACHQC analysis.
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Reed Benjamin L, Warren Jeremy A, Love M Wes, Hodgens Brian D, Cobb William S, Carbonell Alfredo M
Аннотация
BACKGROUND: We investigate the effect of antiplatelet and anticoagulant medications on bleeding complications in patients undergoing ventral hernia repair.
METHODS: The Abdominal Core Health Quality Collaborative registry was queried from 2013 to 2022 for patients who underwent ventral hernia repair, evaluating the association between antiplatelet or anticoagulant use and bleeding complications.
RESULTS: 37,973 patients underwent ventral hernia repair: 11.5 % on antiplatelet therapy alone and 5.8 % on anticoagulation alone. Despite being held, an adjusted regression analysis showed that anticoagulation was associated with an increased risk for postoperative bleeding requiring transfusion (OR 2.4 [1.7-3.4], p < 0.0001), reoperation for postoperative bleeding (OR 6.3 [3.9-10.0], p < 0.0001), and readmission for bleeding complications (OR 4.9 [2.9-8.2], p < 0.0001). Antiplatelet use was not a risk factor for any postoperative bleeding complication.
CONCLUSION: Despite being held preoperatively, patients on anticoagulants are at an increased risk for postoperative hemorrhagic complications. Antiplatelet therapy does not pose the same risk.
METHODS: The Abdominal Core Health Quality Collaborative registry was queried from 2013 to 2022 for patients who underwent ventral hernia repair, evaluating the association between antiplatelet or anticoagulant use and bleeding complications.
RESULTS: 37,973 patients underwent ventral hernia repair: 11.5 % on antiplatelet therapy alone and 5.8 % on anticoagulation alone. Despite being held, an adjusted regression analysis showed that anticoagulation was associated with an increased risk for postoperative bleeding requiring transfusion (OR 2.4 [1.7-3.4], p < 0.0001), reoperation for postoperative bleeding (OR 6.3 [3.9-10.0], p < 0.0001), and readmission for bleeding complications (OR 4.9 [2.9-8.2], p < 0.0001). Antiplatelet use was not a risk factor for any postoperative bleeding complication.
CONCLUSION: Despite being held preoperatively, patients on anticoagulants are at an increased risk for postoperative hemorrhagic complications. Antiplatelet therapy does not pose the same risk.