A retrospective study showing the extent of compliance with perioperative guidelines in patients with coronary stents with regard to double antiplatelet therapy. J Clin Anesth 2016 Sep;33:179-84
Date
08/25/2016Pubmed ID
27555160DOI
10.1016/j.jclinane.2016.01.030Scopus ID
2-s2.0-84964598981 (requires institutional sign-in at Scopus site) 1 CitationAbstract
STUDY OBJECTIVE: To evaluate perioperative dual antiplatelet therapy management in patients with previously placed coronary stents.
DESIGN: Retrospective medical record review.
SETTING: Academic medical center.
PATIENTS: A total of 1891 surgical cases performed at Vanderbilt University Medical Center in 2012 were evaluated using a perioperative database. Of these, 161 had complete data records that were evaluated using 2 evidence-based and expert opinion-supported protocols.
INTERVENTIONS: N/A.
MEASUREMENTS: This study is meant to evaluate perioperative antiplatelet management decisions in patients with coronary stents.
MAIN RESULTS: Management decisions were consistent with guidelines regarding antiplatelet therapy in 13% (21/161) of patients. Of the 87% (140/161) of cases where decisions were not consistent, 88% (123/140) were due to discontinuing aspirin preoperatively when there was not a high risk of surgical bleeding.
CONCLUSIONS: This study revealed suboptimal adherence to current perioperative antiplatelet management guidelines in patients with coronary stents. The lack of adherence to current guidelines is concerning and could be used to support the notion of an anesthesiologist-led Perioperative Surgical Home.
Author List
Woolard AA, Ehrenfeld JM, Eagle SS, Wanderer JPAuthor
Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Aspirin
Case Management
Coronary Vessels
Female
Guideline Adherence
Humans
Male
Middle Aged
Perioperative Care
Platelet Aggregation Inhibitors
Retrospective Studies
Stents
Ticlopidine
Treatment Outcome
