Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu, 807, Japan.
Department of Environmental Epidemiology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Surg Today. 2021 Jun;51(6):923-930. doi: 10.1007/s00595-020-02165-6. Epub 2020 Oct 26.
There is little evidence to demonstrate the impact of heparin bridging (HB) in major surgery. This study aimed to evaluate the benefits and risks of HB in lung cancer surgery by comparing HB and non-HB (NHB) groups.
We extracted patients who were taking an anticoagulant, were diagnosed with lung cancer, and underwent lung resection between April 2014 and March 2018 from a nationwide database in Japan. We compared the HB and NHB groups to determine the benefits and risks of HB. The proportion of postoperative thromboembolism and bleeding events between the HB and NHB groups was the primary outcome. We performed propensity score matching to remove any HB assignment bias.
We selected 2416 patients, and among these, 1068 patients had HB and 1348 did not. Propensity score matching extracted 1500 patients: 750 with HB and 750 without HB. After matching, a Chi-square test showed no significant difference in the incidence of postoperative thromboembolism (1.5% vs 0.9%, p value = 0.343) and bleeding events (5.9% vs 4.0%, p value = 0.124) between the two groups.
There was no significant difference in the incidence of postoperative thromboembolism and bleeding in the patients with and those without HB.
目前几乎没有证据表明肝素桥接（HB）对大型手术有影响。本研究旨在通过比较 HB 组和非 HB（NHB）组，评估 HB 在肺癌手术中的获益和风险。
我们从日本全国数据库中提取了 2014 年 4 月至 2018 年 3 月期间正在服用抗凝药物、诊断为肺癌并接受肺切除术的患者。我们比较了 HB 和 NHB 组，以确定 HB 的获益和风险。HB 组和 NHB 组术后血栓栓塞和出血事件的比例是主要结局。我们进行了倾向评分匹配，以消除任何 HB 分配偏倚。
我们选择了 2416 例患者，其中 1068 例患者接受 HB，1348 例患者未接受 HB。倾向评分匹配提取了 1500 例患者：750 例接受 HB，750 例未接受 HB。匹配后，卡方检验显示两组术后血栓栓塞（1.5% vs 0.9%，p 值=0.343）和出血事件（5.9% vs 4.0%，p 值=0.124）的发生率无显著差异。
接受 HB 和未接受 HB 的患者术后血栓栓塞和出血的发生率无显著差异。
