Effects of Perioperative Acetyl Salicylic Acid on Clinical Outcomes in Patients Undergoing Craniotomy for Brain Tumor.
OBJECTIVE
To evaluate the safety of continuing acetyl salicylic acid (ASA) in patients undergoing brain tumor resection. Many patients are on antiplatelet agents that are withheld before elective neurosurgical procedures to reduce bleeding risk. Cessation of ASA in patients with cardiovascular disease is associated with a known increased risk of thrombotic events, especially in patients with coronary stents.


METHODS
The medical records of patients who underwent surgical resection of a brain tumor at the University of Florida from 2010 to 2014 were evaluated. The patients were separated into groups based on preoperative ASA use and whether or not it was stopped before surgery. Patients were evaluated for thrombotic complications, postoperative hemorrhage, estimated blood loss, length of hospital stay, and discharge disposition.


RESULTS
Of the 452 patients analyzed, 368 patients were not on chronic ASA therapy, 55 patients had their ASA discontinued before surgery, and 28 patients were continued on ASA perioperatively. The patients on preoperative ASA were comparable on all collected demographic variables. There were no statistical differences detected between the groups for outcomes including bleeding complications, need for reoperation, or thrombotic complications.


CONCLUSIONS
In this analysis, perioperative low dose ASA use was not associated with increased risk of perioperative complications.
Department of Neurological Surgery, University of Florida, Gainesville, Florida, USA. Electronic address: mrahman@ufl.edu.
Maryam
M
Rahman
Department of Neurological Surgery, University of Florida, Gainesville, Florida, USA.
Lauren L
LL
Donnangelo
Department of Neurological Surgery, University of Florida, Gainesville, Florida, USA.
Dan
D
Neal
Division of Cardiology, Department of Medicine, University of Florida, Gainesville, Florida, USA.
Kiran
K
Mogali
Department of Neurological Surgery, University of Florida, Gainesville, Florida, USA.
Matthew
M
Decker
Division of Cardiology, Department of Medicine, University of Florida, Gainesville, Florida, USA.
Mustafa M
MM
Ahmed
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001932:Brain Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000009:adverse effects; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D059035:Perioperative Period; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000139:chemically induced* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
Acetyl salicylic acid; Antiplatelet therapy; Aspirin; Brain tumor; Neurosurgery; Perioperative complications