A Model for Perioperative Outpatient Management of Anticoagulation in High-Risk Patients: An Evaluation of Effectiveness and Safety

n=47 high-risk patients receiving long-term oral anticoagulant therapy who required surgical procedures. High-risk defined as recent or recurrent venous thromboembolism, atrial fibrillation and a major risk factor, one or more mechanical heart valves, or congestive heart failure with left ventricular ejection fraction less than 30%.

Warfarin discontinued 5 days before procedure, and dalteparin started (5000 units SC once daily, 200 units/kg SC once daily, or 120 units/kg SC twice daily). Dalteparin continued until 24 h before surgery and restarted 12 h after procedure with warfarin, until INR within therapeutic range.

Rates of thromboembolic and hemorrhagic complications in the perioperative periodsafety