Management of Antithrombotic Drugs before Elective Spine Surgery: A Nationwide Web-Based Questionnaire Survey in Japan
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- Tezuka Fumitake
- Department of Orthopedics, Tokushima University
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- Sakai Toshinori
- Department of Orthopedics, Tokushima University
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- Imagama Shiro
- Department of Orthopaedic Surgery/Rheumatology, Nagoya University Graduate School of Medicine
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- Takahashi Hiroshi
- Department of Orthopedic Surgery, Toho University School of Medicine
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- Takaso Masashi
- Department of Orthopaedic Surgery, Kitasato University, School of Medicine
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- Aizawa Toshimi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine
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- Otani Koji
- Department of Orthopedic Surgery, Fukushima Medical University
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- Okuda Shinya
- Department of Orthopedics, Hoshigaoka Medical Center
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- Kato Satoshi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences
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- Kanemura Tokumi
- Department of Orthopaedic Surgery, Konan Kosei Hospital
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- Kawaguchi Yoshiharu
- Department of Orthopedics, University of Toyama
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- Konishi Hiroaki
- Department of Orthopedics, Nagasaki Rosai Hospital
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- Suda Kota
- Hokkaido Spinal Cord Injury Center
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- Terai Hidetomi
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine
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- Nakanishi Kazuo
- Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School
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- Nishida Kotaro
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus
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- Machino Masaaki
- Department of Orthopaedic Surgery/Rheumatology, Nagoya University Graduate School of Medicine
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- Miyakoshi Naohisa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine
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- Murakami Hideki
- Department of Orthopaedic Surgery, Nagoya City University
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- Yamato Yu
- Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine
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- Yukawa Yasutsugu
- Spine Center, Nagoya Kyoritsu Hospital
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- Medical Safety Promotion Committee of The Japanese Society for Spine Surgery and Related Research
- The Japanese Society for Spine Surgery and Related Research
説明
<p>Introduction: The number of patients on antithrombotic drugs for coronary heart disease or cerebrovascular disease has been increasing with the aging of society. We occasionally need to decide whether to continue or discontinue antithrombotic drugs before spine surgery. The purpose of this study is to understand the current perioperative management of antithrombotic drugs before elective spine surgery in Japan.</p><p>Methods: In 2021, members of the Japanese Society for Spine Surgery and Related Research (JSSR) were asked to complete a web-based questionnaire survey that included items concerning the respondents' surgical experience, their policy regarding discontinuation or continuation of antithrombotic drugs, their reasons for decisions concerning the management of antithrombotic drugs, and their experience of perioperative complications related to the continuation or discontinuation of these drugs.</p><p>Results: A total of 1,181 spine surgeons returned completed questionnaires, giving a response rate of 32.0%. JSSR board-certified spine surgeons comprised 75.1% of the respondents. Depending on the management policy regarding antithrombotic drugs for each comorbidity, approximately 73% of respondents discontinued these drugs before elective spine surgery, and about 80% also discontinued anticoagulants. Only 4%-5% of respondents reported continuing antiplatelet drugs, and 2.5% reported continuing anticoagulants. Among the respondents who discontinued antiplatelet drugs, 20.4% reported having encountered cerebral infarction and 3.7% reported encountering myocardial infarction; among those who discontinued anticoagulants, 13.6% reported encountering cerebral embolism and 5.4% reported encountering pulmonary embolism. However, among the respondents who continued antiplatelet drugs and those who continued anticoagulants, 26.3% and 27.2%, respectively, encountered an unexpected increase in intraoperative bleeding, and 10.3% and 8.7%, respectively, encountered postoperative spinal epidural hematoma requiring emergency surgery.</p><p>Conclusions: Our findings indicate that, in principle, >70% of JSSR members discontinue antithrombotic drugs before elective spine surgery. However, those with a discontinuation policy have encountered thrombotic complications, while those with a continuation policy have encountered hemorrhagic complications.</p>
収録刊行物
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- Spine Surgery and Related Research
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Spine Surgery and Related Research 7 (5), 428-435, 2023-09-27
一般社団法人 日本脊椎脊髄病学会
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詳細情報 詳細情報について
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- CRID
- 1390297592730250880
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- ISSN
- 2432261X
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
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- 抄録ライセンスフラグ
- 使用不可