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在积极抗血栓治疗期间进行门诊喉部手术的安全性。

The safety of in-office laryngologic procedures during active antithrombotic therapy.

作者信息

Straub Jeffrey M, Calamari Kevin A, Shin Timothy J, Janse Sarah A, Forrest Lowell A, deSilva Brad W, Matrka Laura A

机构信息

Department of Otolaryngology-Head and Neck Surgery The Ohio State University Columbus Ohio USA.

Department of Biomedical Informatics The Ohio State University Columbus Ohio USA.

出版信息

Laryngoscope Investig Otolaryngol. 2020 Sep 2;5(5):890-894. doi: 10.1002/lio2.451. eCollection 2020 Oct.

Abstract

OBJECTIVES

To determine whether patients undergoing in-office laryngologic procedures on antithrombotic therapy are at increased risk for treatment-related complications.

METHODS

Patients were those who underwent at least one in-office laryngologic procedure with any of three fellowship-trained laryngologists. Procedures were identified by current procedural terminology (CPT) code and included biopsies, excisions, laser ablations, and injections (therapeutic and augmentative). Patients were divided into two groups based on the use of antithrombotic therapy at the time of their procedure. Retrospective chart review was performed to identify any complications, with an average follow-up of 186 days.

RESULTS

Five hundred-sixty-four unique individuals were identified with ages ranging from 18 to 93 years old and with a relatively even distribution between females (45%) and males (55%). They underwent 647 procedures in total, 310 of which were performed while on some form of antithrombotic therapy. Sixteen procedures were associated with complications either during or after the procedure. In comparing overall complication rates, there was no significant difference between non-antithrombotic (2.4%) and antithrombotic (3.3%) cohorts (OR 1.09, 95% CI [0.46-2.60], = .8454).

CONCLUSIONS

In spite of known risks in other settings, antithrombotic agents do not appear to confer increased risk of treatment-related complications during in-office laryngologic procedures, obviating the need for cessation of therapy prior to these interventions.

LEVEL OF EVIDENCE

摘要

目的

确定接受门诊喉部手术的抗血栓治疗患者发生治疗相关并发症的风险是否增加。

方法

患者为接受过至少一次由三位接受过专科培训的喉科医生之一进行的门诊喉部手术的患者。手术通过当前手术操作术语(CPT)代码识别,包括活检、切除、激光消融和注射(治疗性和填充性)。根据手术时是否使用抗血栓治疗将患者分为两组。进行回顾性病历审查以确定任何并发症,平均随访186天。

结果

共识别出564名个体,年龄在18至93岁之间,女性(45%)和男性(55%)分布相对均匀。他们总共接受了647例手术,其中310例是在接受某种形式的抗血栓治疗时进行的。16例手术在术中或术后出现并发症。在比较总体并发症发生率时,非抗血栓治疗组(2.4%)和抗血栓治疗组(3.3%)之间无显著差异(OR 1.09,95%CI[0.46 - 2.60],P = 0.8454)。

结论

尽管在其他情况下存在已知风险,但抗血栓药物在门诊喉部手术期间似乎不会增加治疗相关并发症的风险,因此无需在这些干预措施前停用治疗。

证据水平

4级。

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