Anticoagulation in Emergency General Surgery

  • STATUS
    Recruiting
  • participants needed
    500
  • sponsor
    Methodist Health System
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Updated on 16 February 2024
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Summary

While DOACs are increasing in use in the EGS patient population, the risk of bleeding and the reversal of these agents to reduce hemorrhage is still evolving. Given the paucity of data regarding the impact of DOACs in this patient population, it becomes empiric to identify bleeding patterns and outcomes in the EGS population taking DOACs. We hypothesize that patients taking a DOAC will have a higher bleeding incidence and need for an unplanned intervention secondary to hemorrhage in EGS patients undergoing an urgent or emergent operation when compared to patients taking warfarin and antiplatelets.

Description

Emergency general surgery (EGS) represents illnesses of diverse pathology with urgent/emergent treatment needs being the common denominator.(1) A characteristic feature of EGS is its limitation in patient preparation. It is difficult and often impossible to eliminate certain patient dependent factors to reduce the operative risk. It has been reported that the annual case rate in the EGS population is (1,290 per 100,000) higher than the sum of all cancer diagnoses.1 The EGS burden is substantial and continues to increase. The elderly patient population represents 48% of the overall EGS population. With the increase in the prevalence of atherosclerotic disease in the elderly there has been an increase in the use of antiplatelets and anticoagulants.(2,3)

Details
Condition Emergency General Surgery
Age 18years - 100years
Treatment Emergency general surgery
Clinical Study IdentifierNCT04216394
SponsorMethodist Health System
Last Modified on16 February 2024

Eligibility

 Yes No Not Sure

Inclusion Criteria

All patients who are confirmed to be taking dabigatran, rivaroxaban, apixaban, warfarin and antiplatelet therapy (aspirin, clopidogril, ticagrelor) undergoing an urgent or emergent surgical intervention by the emergency general surgery service within 24 hours of arrival to the hospital
years of age or over

Exclusion Criteria

Prisoners
Pregnant patients
Those who received an index operation at an outside facility and were transferred
Under 18 years of age
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