Perioperative management, kidney function and dialysis status
| Parameter . | N = 60 (perioperative interruptions) . | ||
|---|---|---|---|
| Perioperative management | |||
| Procedure details | Setting, n (%) | Inpatient∗ | 26 (43.3) |
| Outpatient | 34 (56.7) | ||
| Bleeding risk†, n (%) | Low/moderate | 22 (36.7) | |
| High | 38 (63.3) | ||
| Perioperative consultation | Consultation setting, n (%) | In-person | 40 (66.7) |
| Virtual | 20 (33.3) | ||
| Thrombosis medicine consultation, n (%) | 28 (46.7) | ||
| Anesthesiology consultation, n (%) | 46 (76.7) | ||
| Specialist providing anticoagulation management advice, n (%) | Thrombosis | 28 (46.7) | |
| Anesthesiology | 32 (53.3) | ||
| Perioperative anticoagulation | Therapeutic bridging anticoagulation, n (%) | 2 (3.3) | |
| Prophylactic LMWH, n (%) | Preoperative | 1 (1.7) | |
| Postoperative | 7 (11.7) | ||
| Prophylactic UFH, n (%) | Preoperative | 2 (3.3) | |
| Postoperative | 4 (6.7) | ||
| Prophylactic LMWH/UFH duration (d), median (IQR) | Preoperative | 2 (1.3-3.5) | |
| Postoperative | 3 (1.5-5) | ||
| Alternative postoperative antithrombotic regimen implemented‡, n (%) | 5 (8.3) | ||
| Apixaban dose reduction recommended during perioperative consultation, n (%) | 7 (11.7) | ||
| Kidney function and dialysis status | |||
| Documented CKD or kidney failure§, n (%) | 50 (83.3) | ||
| Creatinine|| (umol/L), median (IQR) | 197 (136-290) | ||
| Creatinine clearance||,¶ (mL/min), median (IQR) | 24 (19-27) | ||
| Dialysis anticipated within 6 months, n (%) | 11 (18.3) | ||
| Dialysis#, n (%) | 5 (8.3) | ||
| Parameter . | N = 60 (perioperative interruptions) . | ||
|---|---|---|---|
| Perioperative management | |||
| Procedure details | Setting, n (%) | Inpatient∗ | 26 (43.3) |
| Outpatient | 34 (56.7) | ||
| Bleeding risk†, n (%) | Low/moderate | 22 (36.7) | |
| High | 38 (63.3) | ||
| Perioperative consultation | Consultation setting, n (%) | In-person | 40 (66.7) |
| Virtual | 20 (33.3) | ||
| Thrombosis medicine consultation, n (%) | 28 (46.7) | ||
| Anesthesiology consultation, n (%) | 46 (76.7) | ||
| Specialist providing anticoagulation management advice, n (%) | Thrombosis | 28 (46.7) | |
| Anesthesiology | 32 (53.3) | ||
| Perioperative anticoagulation | Therapeutic bridging anticoagulation, n (%) | 2 (3.3) | |
| Prophylactic LMWH, n (%) | Preoperative | 1 (1.7) | |
| Postoperative | 7 (11.7) | ||
| Prophylactic UFH, n (%) | Preoperative | 2 (3.3) | |
| Postoperative | 4 (6.7) | ||
| Prophylactic LMWH/UFH duration (d), median (IQR) | Preoperative | 2 (1.3-3.5) | |
| Postoperative | 3 (1.5-5) | ||
| Alternative postoperative antithrombotic regimen implemented‡, n (%) | 5 (8.3) | ||
| Apixaban dose reduction recommended during perioperative consultation, n (%) | 7 (11.7) | ||
| Kidney function and dialysis status | |||
| Documented CKD or kidney failure§, n (%) | 50 (83.3) | ||
| Creatinine|| (umol/L), median (IQR) | 197 (136-290) | ||
| Creatinine clearance||,¶ (mL/min), median (IQR) | 24 (19-27) | ||
| Dialysis anticipated within 6 months, n (%) | 11 (18.3) | ||
| Dialysis#, n (%) | 5 (8.3) | ||
LMWH, low-molecular-weight-heparin; UFH, unfractionated heparin.
A procedure was designated as occurring on an inpatient basis when a patient was admitted to hospital for at least an overnight stay.
According to ISTH Perioperative and Critical Care Scientific and Standardization Committee Procedural/Surgical Bleed Risk stratification.
Two patients were maintained on long term prophylactic UFH, 1 was switched to warfarin, 1 was switched to edoxaban 30 mg once daily, and 1 patient had their apixaban discontinued and was replaced with aspirin 81 mg once daily.
Documented diagnosis of CKD or kidney failure within 6 months preceding the perioperative encounter in question. Specific nephrology diagnoses included polycystic kidney disease (n = 5), ischemic nephropathy (n = 5), diabetic nephropathy (n = 4), focal segmental glomerulonephritis (n = 3), C3 glomerulonephritis (n = 2), IgA nephropathy (n = 1) and amyloidosis (n = 1).
Excluding patients undergoing dialysis (n = 55). Creatinine conversion to mg/dL = μmol per liter/88.4.
Creatinine clearance estimated using Cockcroft-Gault formula.
Three patients were receiving intermittent hemodialysis and 2 were receiving peritoneal dialysis.