title: Results of surgery in general surgical patients receiving warfarin: retrospective analysis of 61 patients.
abstract: The aim of this study is to investigate postoperative complications, mortality rates, and to determine the factors affecting mortality on the patients receiving warfarin therapy preoperatively, as well as comparing the results obtained from emergency and elective surgeries. Surgical outcomes of 61 patients on long-term oral anticoagulation with warfarin who underwent surgery in our center were retrospectively reviewed over an 8-year period. Thirty-three (54.1%) patients were female, with a mean age of 53 years. Mitral valve replacement (62.3%) was the most frequent indication for chronic anticoagulation therapy. Twelve out of 61 (19.2%) patients underwent emergency surgery; 59 (96.7%) operations were classified as major surgery. We did not observe any thromboembolic events on patients receiving our bridging therapy protocol. Cardiopulmonary dysfunction (CPD; 19.7%) and hemorrhage (16.4%) were the most encountered postoperative complications. Presence of CPD, bleeding, endocarditis, and mortality were statistically significant for emergency surgeries when compared with the results obtained from elective surgeries. There were 5 (8.2%) deaths observed during follow-up. It was found that advanced age, prolonged duration of operations, and presence of CPD had a statistically significant effect on mortality (P < 0.05). The patients receiving oral anticoagulant had high postoperative complication and mortality rates. This case was more evident in emergency surgeries. It is recommendable that as mortality is more apparent in the patients who undergo emergency surgeries-being older, having long duration of operations as well as CPD. Therefore during the postoperative follow-up process, the patients should be closely monitored.
authors.affiliation: Department of Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Belli
authors.forename: Huseyin Ozgur
authors.initials: HO
authors.lastname: Aytac
authors.forename: Hakan
authors.initials: H
authors.lastname: Yabanoglu
authors.forename: Erdal
authors.initials: E
authors.lastname: Karagulle
authors.forename: Alper
authors.initials: A
authors.lastname: Parlakgumus
authors.forename: Tarik Zafer
authors.initials: TZ
authors.lastname: Nursal
authors.forename: Sedat
authors.initials: S
authors.lastname: Yildirim
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D004630:Emergencies; D005260:Female; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D057234:Preoperative Period; D012189:Retrospective Studies; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Emergency; Morbidity; Mortality; Postoperative complications; Warfarin