Abstract Number: PB0312
Meeting: ISTH 2020 Congress
Background: Although continuing antithrombotic therapy is desirable to prevent perioperative cardiovascular and cerebrovascular diseases, perioperative blood loss remains a concern in patients undergoing diabetic foot surgery
Aims: Assess the impact of continuing chronic antithrombotic therapy on blood loss and major bleeding events.
Methods: We classified 54 consecutive patients undergoing diabetic foot surgery into 2 groups: (1) patients taking antiplatelet agents, vitamin K antagonists, and/or direct oral anticoagulants, referred to as the continuing antithrombotic therapy group (n = 22); and (2) patients not receiving these agents, referred to as the no antithrombotic therapy group (n = 32). During the study period, antithrombotic agents were continued perioperatively in all patients receiving antithrombotic therapy. Surgical procedures were performed without the use of a pneumatic tourniquet or drain. Screening for deep vein thrombosis was routinely performed before and after diabetic foot surgery.
Results: The perioperative blood loss after diabetic foot surgery did not differ significantly between the continuing antithrombotic therapy group and the no antithrombotic therapy group at 1 day postoperatively (412 ± 173 compared with 438 ± 311 mL [95% confidence interval (CI) of the difference, -162 to 74 mL]; p = 0.44), 3 days postoperatively (798 ± 311 compared with 822 ± 301 mL [95% CI, -106 to 129 mL]; p = 0.79), and 7 days postoperatively (823 ± 313 compared with 850 ± 242 mL [95% CI, -121 to 104 mL]; p = 0.83). No patients in the continuing antithrombotic therapy group and 2 patients in the no antithrombotic therapy group had allogeneic blood transfusion (p = 1). No major bleeding events occurred in the continuing antithrombotic therapy group.
Conclusions: Perioperative blood loss in patients continuing chronic antithrombotic therapy during diabetic foot surgery was not significantly different from that in patients receiving no chronic antithrombotic therapy.
To cite this abstract in AMA style:Volkova Y, Dmytriiev D. A Strategy of Continued Antiplatelet Agents, Vitamin K Antagonists, and Direct Oral Anticoagulants throughout the Perioperative Period of Diabetic Foot Surgery in Patients Receiving Chronic Antithrombotic Therapy [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/a-strategy-of-continued-antiplatelet-agents-vitamin-k-antagonists-and-direct-oral-anticoagulants-throughout-the-perioperative-period-of-diabetic-foot-surgery-in-patients-receiving-chronic-antithromb/. Accessed March 3, 2021.
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