title: Effects of heparin bridging anticoagulation on perioperative bleeding and thromboembolic risks in patients undergoing abdominal malignancy surgery.
abstract: Recent publications provided controversial results indicating that perioperative heparin bridging anticoagulation (HBA) increased the bleeding risk without decreasing the thromboembolic risk in patients undergoing minor surgery. To investigate if this is also the case in high-risk patients undergoing major abdominal malignancy surgery, we retrospectively collected data of 3268 patients over a 10-year period. After the interruption of preoperative antithrombotic agents, HBA was initiated with a prophylactic-dose of unfractionated heparin in 133 patients (HBA group), and 62 patients did not receive HBA (non-HBA group). The incidence of exogenous blood transfusion (EBT) and thromboembolic events (TEEs) within 30 days after surgery were compared between the HBA and non-HBA groups. The results showed that the incidence of EBT and TEEs was similar between the two groups (23.3 vs 19.4 %; P = 0.535) and (4.1 vs 3.2 %; P = 0.821), respectively. The amount of intraoperative bleeding and the length of postoperative hospital stay were also similar [median (quantile 1-3); 192 (71-498) vs 228 ml (100-685); P = 0.422] and [12 (9-19) vs 14.5 days (10-21); P = 0.052], respectively. These findings may suggest it is unlikely that prophylactic-dose HBA affects bleeding and thromboembolic risks in patients undergoing major abdominal malignancy surgery.
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan. kaono@city.fukuyama.hiroshima.jp.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Ono
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Hidekuni
authors.initials: H
authors.lastname: Hidaka
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Koyama
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Ishii
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Taguchi
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Mako
authors.initials: M
authors.lastname: Kosaka
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Okazaki
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Wakana
authors.initials: W
authors.lastname: Tanimoto
authors.affiliation: Department of Anesthesiology and Oncological Pain Medicine, Fukuyama City Hospital, 5-23-1, Zao-Cho, Fukuyama, 721-8511, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Katayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001803:Blood Transfusion; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology*; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D012306:Risk; D013923:Thromboembolism / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: Bleeding; Heparin bridging anticoagulation; Malignancy surgery; Perioperative; Thromboembolism