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The Perioperative Management of Warfarin Therapy

The Perioperative Management of Warfarin Therapy EDITORIAL F THERE is one thing that can be said with cer- oral anticoagulant therapy is discontinued several days tainty about the perioperative management of before the procedure. Such therapy requires an inpa- oral anticoagulation as reviewed by Dunn and tient admission; is costly, labor intensive, and inconve- Turpie in this issue of the ARCHIVES,itisthe nient; and carries potential risk. Low-molecular-weight I authors’ statement that “It is not possible to draw heparin (LMWH) offers a simpler alternative, since sub- firm conclusions on the relative efficacy and safety of dif- cutaneous, unmonitored therapy can be delivered at home. ferent management strategies using the available litera- Retrospective and prospective cohort studies using LMWH 5-7 ture owing to variations in patient populations, proce- for a variety of indications are beginning to emerge as dures, anticoagulation regimens, definitions of events, and summarized in the review by Dunn and Turpie. One can durations of follow-up.” However, this is a management also extrapolate the results of LMWH trials for the treat- dilemma that is too important to say there is no answer. ment of specific conditions and apply them to the peri- We must look at the available evidence, regardless of its operative bridging encounter, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

The Perioperative Management of Warfarin Therapy

Ansell, Jack E.
JAMA Internal Medicine , Volume 163 (8) – Apr 28, 2003
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References (13)

Publisher
American Medical Association
Copyright
Copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinte.163.8.881
pmid
12719195
Publisher site
See Article on Publisher Site

Abstract

EDITORIAL F THERE is one thing that can be said with cer- oral anticoagulant therapy is discontinued several days tainty about the perioperative management of before the procedure. Such therapy requires an inpa- oral anticoagulation as reviewed by Dunn and tient admission; is costly, labor intensive, and inconve- Turpie in this issue of the ARCHIVES,itisthe nient; and carries potential risk. Low-molecular-weight I authors’ statement that “It is not possible to draw heparin (LMWH) offers a simpler alternative, since sub- firm conclusions on the relative efficacy and safety of dif- cutaneous, unmonitored therapy can be delivered at home. ferent management strategies using the available litera- Retrospective and prospective cohort studies using LMWH 5-7 ture owing to variations in patient populations, proce- for a variety of indications are beginning to emerge as dures, anticoagulation regimens, definitions of events, and summarized in the review by Dunn and Turpie. One can durations of follow-up.” However, this is a management also extrapolate the results of LMWH trials for the treat- dilemma that is too important to say there is no answer. ment of specific conditions and apply them to the peri- We must look at the available evidence, regardless of its operative bridging encounter,

Journal

JAMA Internal Medicine – American Medical Association

Published: Apr 28, 2003

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