A retrospective study showing the extent of compliance with perioperative guidelines in patients with coronary stents with regard to double antiplatelet therapy |
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| Affiliation: | 1. University of Tennessee Health Science Center, Memphis, TN;2. Department of Anesthesiology, Vanderbilt University, Nashville, TN;3. Department of Biomedical Informatics, Vanderbilt University, Nashville, TN;4. Department of Surgery, Vanderbilt University, Nashville, TN;1. Assistant Professor, Department of Anesthesiology, The University of Texas Medical School, Houston, TX, USA;2. Joseph C. Gabel Professor and Chair, Department of Anesthesiology, The University of Texas Medical School, Houston, TX, USA;1. Faculty of Medicine, The University of Calgary, Medical Class of 2016, 4212 Bowness Road NW, Calgary, AB T3B0A3, Canada;2. Department of Anesthesia, Foothills Medical Centre, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada;3. Anesthesia Residency Program, C-229 Foothills Medical Centre, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada;4. University of Calgary, Rockyview General Hospital, 7007 14 St SW, Calgary, AB T2V 1P9, Canada;5. South Health Campus, Calgary Health Region, 4448 Front Street, Calgary, AB T3M 1M4, Canada;1. Division of Cardiology, “S.G. Moscati”, Avellino, Italy;2. Department of Cardiology, UMC St Radboud, Nijmegen, The Netherlands;3. Division of Cardiology, Ospedale “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy;4. Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy;1. Department of Anesthesiology, Tri-Service General Hospital, and National Defense Medical Center, Taipei, Taiwan;2. Division of Oromaxillary Surgery, Department of Dentistry, Tri-Service General Hospital, and National Defense Medical Center, Taipei, Taiwan |
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| Abstract: | Study objectiveTo evaluate perioperative dual antiplatelet therapy management in patients with previously placed coronary stents.DesignRetrospective medical record review.SettingAcademic medical center.PatientsA 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.InterventionsN/A.MeasurementsThis study is meant to evaluate perioperative antiplatelet management decisions in patients with coronary stents.Main resultsManagement 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.ConclusionsThis 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. |
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