Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study
Introduction: This study aimed to standardize perioperative interruption of antiplatelet agents in patients undergoing cervical spinal surgery and investigate the incidence of epidural hematoma and thrombotic complications. Methods: A total of 153 patients, consisting of 85 men and 68 women, were in...
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The Japanese Society for Spine Surgery and Related Research
2024-11-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/8/6/8_2024-0017/_pdf/-char/en |
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| author | Gentaro Kumagai Kanichiro Wada Toru Asari Yoshiro Nitobe Kotaro Aburakawa Yasuyuki Ishibashi |
| author_facet | Gentaro Kumagai Kanichiro Wada Toru Asari Yoshiro Nitobe Kotaro Aburakawa Yasuyuki Ishibashi |
| author_sort | Gentaro Kumagai |
| collection | DOAJ |
| description | Introduction: This study aimed to standardize perioperative interruption of antiplatelet agents in patients undergoing cervical spinal surgery and investigate the incidence of epidural hematoma and thrombotic complications.
Methods: A total of 153 patients, consisting of 85 men and 68 women, were included in this study. Their mean age was 65.5 years. They were divided into two groups: Groups A and B. Group A (139 patients) did not receive preoperative antiplatelet agents, and Group B (14 patients) resumed antiplatelet agents from 7 or 14 days presurgery to 3 days postsurgery. Our analysis encompassed demographic data before surgery, postoperative magnetic resonance image-based assessment of radiological epidural hematoma (EH), and complications such as symptomatic hematoma, blood transfusion, stroke, and venous thromboembolism after surgery.
Results: The frequency of medical conditions, such as hypertension, diabetes, and hyperlipidemia, was significantly higher in Group B than in Group A. The CHADS2 scores, which serve as a clinical prediction rule for estimating stroke risk, were significantly higher in Group B than in Group A. In contrast, the intraoperative blood loss was significantly lower in Group B than in Group A. There was no significant difference in radiologically severe EH, hemorrhage, and thrombotic complications between the two groups. Interestingly, none of the patients in Group B had hemorrhagic and thrombotic complications.
Conclusions: Our standardized perioperative management of antiplatelet agents did not affect the incidence of radiological EH, hemorrhage, and thrombotic complications in patients undergoing cervical spinal surgery. |
| format | Article |
| id | doaj-art-aa19c048375649eaa06b88de58795bb4 |
| institution | Kabale University |
| issn | 2432-261X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj-art-aa19c048375649eaa06b88de58795bb42024-12-08T23:39:13ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2024-11-018656857410.22603/ssrr.2024-00172024-0017Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort StudyGentaro Kumagai0Kanichiro Wada1Toru Asari2Yoshiro Nitobe3Kotaro Aburakawa4Yasuyuki Ishibashi5Department of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineDepartment of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineDepartment of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineDepartment of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineDepartment of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineDepartment of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineIntroduction: This study aimed to standardize perioperative interruption of antiplatelet agents in patients undergoing cervical spinal surgery and investigate the incidence of epidural hematoma and thrombotic complications. Methods: A total of 153 patients, consisting of 85 men and 68 women, were included in this study. Their mean age was 65.5 years. They were divided into two groups: Groups A and B. Group A (139 patients) did not receive preoperative antiplatelet agents, and Group B (14 patients) resumed antiplatelet agents from 7 or 14 days presurgery to 3 days postsurgery. Our analysis encompassed demographic data before surgery, postoperative magnetic resonance image-based assessment of radiological epidural hematoma (EH), and complications such as symptomatic hematoma, blood transfusion, stroke, and venous thromboembolism after surgery. Results: The frequency of medical conditions, such as hypertension, diabetes, and hyperlipidemia, was significantly higher in Group B than in Group A. The CHADS2 scores, which serve as a clinical prediction rule for estimating stroke risk, were significantly higher in Group B than in Group A. In contrast, the intraoperative blood loss was significantly lower in Group B than in Group A. There was no significant difference in radiologically severe EH, hemorrhage, and thrombotic complications between the two groups. Interestingly, none of the patients in Group B had hemorrhagic and thrombotic complications. Conclusions: Our standardized perioperative management of antiplatelet agents did not affect the incidence of radiological EH, hemorrhage, and thrombotic complications in patients undergoing cervical spinal surgery.https://www.jstage.jst.go.jp/article/ssrr/8/6/8_2024-0017/_pdf/-char/enspinal surgeryantiplatelet agentsinterruption periodepidural hematoma |
| spellingShingle | Gentaro Kumagai Kanichiro Wada Toru Asari Yoshiro Nitobe Kotaro Aburakawa Yasuyuki Ishibashi Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study Spine Surgery and Related Research spinal surgery antiplatelet agents interruption period epidural hematoma |
| title | Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study |
| title_full | Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study |
| title_fullStr | Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study |
| title_full_unstemmed | Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study |
| title_short | Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study |
| title_sort | primary results of our protocol for standardization of perioperative antiplatelet agent management on the incidence of epidural hematoma and thrombotic complications in posterior cervical surgery a prospective cohort study |
| topic | spinal surgery antiplatelet agents interruption period epidural hematoma |
| url | https://www.jstage.jst.go.jp/article/ssrr/8/6/8_2024-0017/_pdf/-char/en |
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