Background: For some patients, the performance of a planned surgery depends on the adjustment of their daily antithrombotic medication.

Aims: The aim of this study was to evaluate the consequences of the non-strict compliance with the published recommendations on the morbidity and mortality of patients.

Methods: We conducted a prospective cohort observational monocentric study in an academic hospital over 6 months in 2019. 
All patients on antithrombotic agents scheduled for an elective surgery were included. 
The endpoints were morbidity and mortality at 1 month, compliance with local and French-speaking guidelines, blood loss during the surgery, and length of stay.

Results: Among the 679 patients included in the study, 77 complications were recorded (11,3%). 19 patients had a haemorrhage event and 6 died of it, 30 patients had an ischemic event and 4 died of it, 28 died of another cause. Forty percent anaesthesia consultations complied with the french-guidelines, 75.8% with local recommendations. The association was not was not statistically significant regarding morbidity and adherence to local guidelines (p-value = 0.12) but statistically significant with French speaking guidelines (p-value = 0.027). Regarding guidelines respect and survival at 1 month, the association was not statistically significant with local guidelines (p-value = 0.80) and with french-speaking guidelines (p-value = 0.23).
No statistical relation can be made regarding compliance with recommendations and the volume of intraoperative bleeding, nor with the length of stay.

Conclusions: No association was found between adherence to local guidelines and morbi-mortality, but association was found with french-speaking ones.  

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/anticoagulation-and-antiplatelet-management-during-the-perioperative-period-a-daily-practice-cohort-prospective-study/