Deprecated : Return type of DrupalCacheArray::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 362 Deprecated : Return type of DrupalCacheArray::offsetGet($offset) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 369 Deprecated : Return type of DrupalCacheArray::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 381 Deprecated : Return type of DrupalCacheArray::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 388
bleeding
en
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Periprocedural Bridging in Patients with Venous Thromboembolism: A Systematic Review
<div class="field field-name-field-artifact-uploaded-date field-type-datetime field-label-inline clearfix">
<div class="field-label">Date Added: </div>
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<div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-06-19T00:00:00-05:00">June 19, 2019</span></div>
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<div class="field field-name-field-artifact-journal field-type-text field-label-inline clearfix">
<div class="field-label">Journal/Publication: </div>
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<div class="field-item even">The American Journal of Medicine</div>
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<div class="field field-name-field-artifact-published-date field-type-datetime field-label-inline clearfix">
<div class="field-label">Publication Date: </div>
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<div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-06-16T00:00:00-05:00">June 16, 2019</span></div>
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<div class="field field-name-field-artifact-issue field-type-text field-label-inline clearfix">
<div class="field-label">Issue: </div>
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<div class="field-item even">6</div>
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<div class="field field-name-field-artifact-volume field-type-text field-label-inline clearfix">
<div class="field-label">Volume: </div>
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<div class="field-item even">132</div>
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</div>
<div class="field field-name-field-artifact-pages field-type-text field-label-inline clearfix">
<div class="field-label">Pages: </div>
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<div class="field-item even"> 722-732.e7</div>
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<div class="field field-name-field-artifact-url field-type-link-field field-label-inline clearfix">
<div class="field-label">URL: </div>
<div class="field-items">
<div class="field-item even"><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Periprocedural%20Bridging%20in%20Patients%20with%20Venous%20Thromboembolism%3A%20A%20Systematic%20Review" target="_blank">Periprocedural Bridging in Patients with Venous Thromboembolism: A Systematic Review.</a></div>
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<div class="field field-name-field-artifact-type field-type-taxonomy-term-reference field-label-inline clearfix">
<div class="field-label">Type: </div>
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<div class="field-item even">Meta-analyses, Reviews, and Guidelines</div>
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<div class="field field-name-field-artifact-format field-type-taxonomy-term-reference field-label-inline clearfix">
<div class="field-label">Format: </div>
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<div class="field-item even">Article</div>
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<div class="field field-name-field-artifact-doi-1 field-type-text field-label-inline clearfix">
<div class="field-label">DOI (1): </div>
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<div class="field-item even">10.1016/j.amjmed.2019.01.004</div>
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<div class="field field-name-field-artifact-keywords field-type-taxonomy-term-reference field-label-above">
<div class="field-label">Keywords </div>
<div class="field-items">
<div class="field-item even"><a href="/tags/warfarin" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">warfarin</a></div>
<div class="field-item odd"><a href="/tags/risk-assessment" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">risk assessment</a></div>
<div class="field-item even"><a href="/tags/hemorrhage" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">hemorrhage</a></div>
<div class="field-item odd"><a href="/tags/anticoagulants" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">anticoagulants</a></div>
<div class="field-item even"><a href="/tags/bleeding" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">bleeding</a></div>
<div class="field-item odd"><a href="/tags/bridging" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Bridging</a></div>
<div class="field-item even"><a href="/tags/periprocedural" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Periprocedural</a></div>
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</div>
<div class="field field-name-field-artifact-mesh field-type-taxonomy-term-reference field-label-above">
<div class="field-label">MeSH </div>
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<div class="field-item even"><a href="/mesh/venous-thromboembolism" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Venous Thromboembolism</a></div>
<div class="field-item odd"><a href="/mesh/anticoagulants" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">anticoagulants</a></div>
<div class="field-item even"><a href="/mesh/incidence" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">incidence</a></div>
<div class="field-item odd"><a href="/mesh/confidence-intervals" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Confidence Intervals</a></div>
<div class="field-item even"><a href="/mesh/hemorrhage" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">hemorrhage</a></div>
<div class="field-item odd"><a href="/mesh/cohort-studies" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">cohort studies</a></div>
<div class="field-item even"><a href="/mesh/vitamin-k" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Vitamin K</a></div>
<div class="field-item odd"><a href="/mesh/risk-assessment" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">risk assessment</a></div>
</div>
</div>
<div class="field field-name-field-artifact-editor-note field-type-text-long field-label-hidden">
<div class="field-items">
<div class="field-item even"><p>This systematic review of 28 cohort studies suggests that anticoagulation bridging in patients on warfarin for procedures is probably both unwise (increased bleeding) and unnecessary (no reduction in thromboembolic risk) . </p>
<p>James W. Mold, MD, MPH</p>
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<div class="field field-name-field-artifact-text-availability field-type-list-text field-label-hidden">
<div class="field-items">
<div class="field-item even">Free full text</div>
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<div class="field-item even"><div class="view view-artifact-docs view-id-artifact_docs view-display-id-block view-dom-id-f0d9d0a65db404765e275a30094fc828">
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<div class="views-row views-row-1 views-row-odd views-row-first views-row-last">
<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Periprocedural%20Bridging%20in%20Patients%20with%20Venous%20Thromboembolism%3A%20A%20Systematic%20Review" class="btn btn-primary" target="_blank">View</a> </div>
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<div class="field field-name-body field-type-text-with-summary field-label-hidden">
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<div class="field-item even" property="content:encoded"><p>Abstract</p>
<p>BACKGROUND:</p>
<p>Vitamin K antagonists (VKA) are the most widely used anticoagulants, and bridging is commonly administered during periprocedural VKA interruption. Given the unclear benefits and risks of periprocedural bridging in patients with previous venousthromboembolism, we aimed to assess recurrent venous thromboembolism and bleeding outcomes with and without bridging in this population.</p>
<p>METHODS:</p>
<p>We performed a systematic review searching the PubMed and Embase databases from inception to December 7, 2017 for randomized and nonrandomized studies that included adults with previous venous thromboembolism requiring VKA interruption to undergo an elective procedure, and that reported venous thromboembolism or bleeding outcomes. Quality of evidence was graded by consensus.</p>
<p>RESULTS:</p>
<p>We included 28 cohort studies (20 being single-arm cohorts) with, overall, 6915 procedures for analysis. In 27 studies reporting perioperative venous thromboembolism outcomes, the pooled incidence of recurrent venous thromboembolism with bridging was 0.7% (95% confidence interval [CI], 0.4%-1.2%) and 0.5% (95% CI, 0.3%-0.8%) without bridging. Eighteen studies reported major or nonmajor bleeding outcomes. The pooled incidence of any bleeding was 3.9% (95% CI, 2.0%-7.4%) with bridging and 0.4% (95% CI, 0.1%-1.7%) without bridging. In bridged patients at high thromboembolic risk, the pooled incidence for venous thromboembolism was 0.8% (95% CI, 0.3%-2.5%) and 7.5% (95% CI, 3.1%-17.4%) for any bleeding. Quality of available evidence was very low, primarily due to a high risk of bias of included studies.</p>
<p>CONCLUSIONS:</p>
<p>Periprocedural bridging increases the risk of bleeding compared with VKA interruption without bridging, without a significant difference in periprocedural venous thromboembolism rates.</p>
<p>Copyright © 2019 Elsevier Inc. All rights reserved.</p>
<p>KEYWORDS:</p>
<p>Anticoagulants; Bleeding; Bridging; PROSPERO; Periprocedural; Venous thromboembolism; registration number CRD42017074710</p>
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<div class="field field-name-field-resource-author field-type-taxonomy-term-reference field-label-inline clearfix">
<div class="field-label">Author/s: </div>
<div class="field-items">
<div class="field-item even">Baumgartner, C., de Kouchkovsky, I., Whitaker, E., Fang, M.C.</div>
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Wed, 19 Jun 2019 20:00:05 +0000
Brian Desmarais
617 at https://www.rpr.lib.ok.us