Key result
Resuming direct oral anticoagulants within 72 hours postoperatively was not associated with increased thrombotic events, and resumption after 72 hours had a low rate of thrombotic complications.
Why the study?
The authors aimed to review recommendations for postoperative resumption of DOACs and evaluate complications at 30 days postoperatively.
Does the timing of perioperative DOAC resumption affect 30-day postoperative complication rates in patients receiving DOAC therapy?
Cohort
Does the timing of perioperative DOAC resumption affect 30-day postoperative complication rates in patients receiving DOAC therapy?
Answers are grounded in this paper and cite their sources.
Withholding DOACs for 48 to 72 hours before surgery and resuming them 48 to 72 hours after surgery appears safe without increasing thrombotic events.
OBJECTIVE: We aimed to review recommendations for the postoperative resumption of direct oral anticoagulants (DOACs) and report complications 30 days postoperatively. METHODS: We retrospectively reviewed patients receiving DOAC therapy who underwent preoperative evaluations from January 1, 2015 through May 30, 2018. We noted days that DOAC therapy was withheld, postoperative time until resumption of the DOAC, and complications within 30 postoperative days. RESULTS: 0.02). The total time without DOACs did not affect the complication rates. CONCLUSIONS: We suggest withholding DOACs for 48 to 72 hours before surgery and resuming them 48 to 72 hours after surgery, if safe. The interruption of therapy was not associated with an increase in thrombotic events for patients who resumed DOACs within 72 hours postoperatively. Patients who resumed DOACs after 72 hours postoperatively had a low rate of thrombotic complications.
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Alvarado et al. (2021) conducted a cohort in Patients receiving DOAC therapy undergoing surgery. Direct oral anticoagulants (DOACs) was evaluated on Complications within 30 postoperative days (p=0.02). Resuming direct oral anticoagulants within 72 hours postoperatively was not associated with increased thrombotic events, and resumption after 72 hours had a low rate of thrombotic complications.
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