Perioperative Anticoagulation Practices of Surgeons in a Health System

Abstract

Several different management strategies for patients receiving long-term warfarin therapy who require surgery have been recommended in the literature. A recent article by Kearon and Hirsch made new recommendations based on estimating the risk of thromboembolism and bleeding from randomized trials and prospective studies. Because of the potential for variability in practice patterns, we surveyed physicians in our health system to identify their perioperative anticoagulation practices. Our results confirm variability in practice patterns. Perioperative intravenous heparin was the most frequently reported method of prophylaxis. Fifty-three percent of the surveyed physicians admitted patients to the hospital two or more days prior to surgery to receive prophylaxis. Further research is necessary to determine optimal management of perioperative anticoagulation.