title: Current practice of antiplatelet and anticoagulation management in post-cardiac surgery patients: a national audit.
abstract: The Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery recently published a guideline on antiplatelet and anticoagulation management in cardiac surgery. We aimed to assess the awareness of the current guideline and adherence to it in the National Health Service through this National Audit. We designed a questionnaire consisting of nine questions covering various aspects of antiplatelet and anticoagulation management in post-cardiac surgery patients. A telephonic survey of the on-call cardiothoracic registrars in all the cardiothoracic centres across the UK was performed. All 37 National Health Service hospitals in the UK with 242 consultants providing adult cardiac surgical service were contacted. Twenty (54%) hospitals had a unit protocol for antiplatelet and anticoagulation management in post-cardiac surgery. Only 23 (62.2%) registrars were aware of current European Association for Cardio-Thoracic Surgery guidelines. Antiplatelet therapy is variable in the cardiac surgical units across the country. Low-dose aspirin is commonly used despite the recommendation of 150-300 mg. The loading dose of aspirin within 24 h as recommended by the guideline is followed only by 60.7% of surgeons. There was not much deviation from the guideline with respect to the anticoagulation therapy.
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital of South Manchester, Manchester, UK. sharathhosmane@gmail.com
authors.forename: Sharath
authors.initials: S
authors.lastname: Hosmane
authors.forename: Rashmi
authors.initials: R
authors.lastname: Birla
authors.forename: Adrian
authors.initials: A
authors.lastname: Marchbank
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001364:Awareness; D006348:Cardiac Surgical Procedures / Q000592:standards; D002985:Clinical Protocols; D004363:Drug Utilization; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008485:Medical Audit; D008505:Medical Staff, Hospital / Q000592:standards; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors