Factors associated with bleeding complications in hernia repair of warfarin users

DUMLU E. G., Kilinc I., PARLAK Ö., ÖZSOY M., KILIÇ M.

REVISTA DA ASSOCIACAO MEDICA BRASILEIRA, cilt.67, sa.11, ss.1605-1609, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 67 Sayı: 11
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1590/1806-9282.20210670
  • Dergi Adı: REVISTA DA ASSOCIACAO MEDICA BRASILEIRA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
  • Sayfa Sayıları: ss.1605-1609
  • Anahtar Kelimeler: Inguinal hernia, Anticoagulants, Warfarin, Low-molecular-weight heparin, MOLECULAR-WEIGHT HEPARIN, BRIDGING THERAPY, ANTICOAGULATION, SURGERY, MANAGEMENT, PATIENT
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

OBJECTIVE: In this retrospective study, we aimed to determine factors associated with bleeding complications in patients on long-term METHODS: Two-year hospital records yielded 44 inguinal hernia repair patients on long-term warfarin (26 men, 4 women, aged 57.4 [38-72] years). All patients were managed with LMWH bridging. Patient and operative characteristics, LMWH bridging characteristics, and international normalized ratio (INR) values were compared between patients with and without postoperative bleeding complications. RESULTS: Indication for warfarin use was heart valve disease (n=15), atrial fibrillation (n=7), deep venous thrombosis (n=3), cerebrovascular event (n=3), and pulmonary embolism (n=2). Four of the operations were urgent, while the remaining were elective. There were four ecchymosis cases and three hematoma cases in a total of seven patients. Baseline (2.94 +/- 0.26 versus 2.16 +/- 0.38, p<0.001) and preoperative INR values (1.69 +/- 0.67 versus 1.31 +/- 0.35, p=0.027) were significantly higher, while postoperative INR values (1.04 +/- 0.09 versus 1.2 +/- 0.13, p=0.004) were significantly lower in patients having bleeding complications. CONCLUSIONS: Baseline, preoperative INR, and postoperative INR were the only variables associated with postoperative bleeding complications in patients undergoing LMWH-bridged inguinal hernia repair. We suggest close monitoring of INR levels in long-term warfarin users, even for relatively low-bleeding risk operations such as inguinal hernia repair.