title: Perioperative Risks of Dietary and Herbal Supplements.
abstract: Patients undergoing surgery often use Dietary and Herbal Supplements (DHS). We explored the risk of DHS-drug interactions in the perioperative setting.
  
  
  
  In this cross-sectional prospective study, participants hospitalized for surgery completed a questionnaire regarding DHS use. We used pharmacological databases to assess DHS-drug interactions. We then applied univariate and multivariate logistic regression analyses to characterize patients at risk for DHS-drug interactions.
  
  
  
  Of 526 interviewees, 230 (44%) patients reported DHS use, with 16.5% reporting using DHS that could potentially interact with anesthesia. Twenty-four (10%) patients used DHS that could potentially interact with antithrombotic drugs taken perioperatively. The medical files of three patients included reports of intraoperative bleeding. The patient files of only 11% of DHS users documented DHS use.
  
  
  
  DHS use poses a significant health risk due to potential interactions. Guidelines should emphasize perioperative management of DHS use.
authors.affiliation: Internal Medicine B Department, Bnai Zion Medical Center, Golomb 47, 3339419, Haifa, Israel. ilana.levy@b-zion.org.il.
authors.forename: Ilana
authors.initials: I
authors.lastname: Levy
authors.affiliation: Complementary Medicine Department, Bnai Zion Medical Center, Haifa, Israel.|School of Public Health, University of Haifa, Haifa, Israel.
authors.forename: Samuel
authors.initials: S
authors.lastname: Attias
authors.affiliation: Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.|Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Western Galilee District, Haifa, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
authors.affiliation: Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.|Clinical Pharmacology Unit, Haemek Medical Center, Afula, Israel.
authors.forename: Lee
authors.initials: L
authors.lastname: Goldstein
authors.affiliation: Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.|Surgery Department, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Matter
authors.affiliation: Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.|Anesthesiology Department, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Somri
authors.affiliation: Internal Medicine B Department, Bnai Zion Medical Center, Golomb 47, 3339419, Haifa, Israel.|Complementary Medicine Department, Bnai Zion Medical Center, Haifa, Israel.|Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
mesh_terms: D000777:Anesthetics / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006470:Hemorrhage / Q000139:chemically induced*; D041743:Herb-Drug Interactions; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007431:Intraoperative Complications / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D011446:Prospective Studies
chemical_list: D000777:Anesthetics; D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006993:Hypnotics and Sedatives; D010975:Platelet Aggregation Inhibitors