University of South Carolina School of Medicine-Greenville, Department of Surgery, Prisma Health Upstate, 905 Verdae Blvd Suite 202, Greenville, SC, 29607, USA.
University of South Carolina School of Medicine-Greenville, Department of Surgery, Prisma Health Upstate, 905 Verdae Blvd Suite 202, Greenville, SC, 29607, USA.
Am J Surg. 2024 Oct;236:115856. doi: 10.1016/j.amjsurg.2024.115856. Epub 2024 Jul 18.
We investigate the effect of antiplatelet and anticoagulant medications on bleeding complications in patients undergoing ventral hernia repair.
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.
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.
Despite being held preoperatively, patients on anticoagulants are at an increased risk for postoperative hemorrhagic complications. Antiplatelet therapy does not pose the same risk.
我们研究了抗血小板和抗凝药物对接受腹疝修补术患者出血并发症的影响。
从 2013 年至 2022 年，对接受腹疝修补术的患者进行了腹部核心健康质量协作注册中心的查询，评估抗血小板或抗凝药物的使用与出血并发症之间的关联。
37973 例患者接受了腹疝修补术：11.5%单独使用抗血小板治疗，5.8%单独使用抗凝治疗。尽管已停药，但调整后的回归分析显示，抗凝与术后出血需要输血（OR 2.4 [1.7-3.4]，p<0.0001）、术后出血再次手术（OR 6.3 [3.9-10.0]，p<0.0001）和因出血并发症再入院（OR 4.9 [2.9-8.2]，p<0.0001）的风险增加相关。抗血小板治疗不是任何术后出血并发症的危险因素。
尽管术前停药，但使用抗凝药物的患者术后出血并发症的风险增加。抗血小板治疗不会带来同样的风险。
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