A Knopf1, L Freudelsperger, T Stark, E Scherer. 1. Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland, a.knopf@lrz.tum.de.
Abstract
BACKGROUND:Patients with antiplatelet and antithrombotic therapy (AP/AT) represent a substantial proportion of ear, nose and throat (ENT) patients. Despite the ubiquitous consideration of bleeding and ischemic/thrombembolic risk, no detailed assessment of the perioperative setting in an ENT cohort is available in the literature. OBJECTIVES: The goal of the present work is to give a detailed assessment of patients with AP/AT in an ENT cohort resulting in ENT-specific recommendations for daily routine. MATERIALS AND METHODS: In all, 400 randomized patients were asked regardinganalgetic therapy in acute pain. Medical data of 5211 patients who underwent head and neck surgery were analyzed for AP/AT therapy. Therapeutic strategies, the perioperative AP/AT therapy, duration of intensive care treatment and hospitalization (ICT/H), application of erythrocytes and internistic/neurolocigal complication data were analyzed in patients with/without AP/AT. RESULTS: Nearly 75 % of our patients were taking AP/AT due to coronary heart disease (CHD), peripheral arterial disease (PAD), cardiac arrhythmia, or cardiovascular disease (CVD). Patients' questionnaire revealed that 31 % of our patients use acetylsalicylic acid in acute pain, which represents 10 % of the overall AP/AT cohort. Head and neck surgery in patients with AP/AT showed an elevated bleeding frequency (p = 0.006) without an elevated risk for internistic/neurological complications. ICT/H were remarkably prolonged (p = 0.006; p = 0.0004). DISCUSSION: Head and neck surgery in patients with AP/AT can be routinely performed. Indication for intensive care, endotracheal intubation, and tracheostomy should be made generously due to high requirements of airway management in ENT. Ischemic/thrombembolic and bleeding risk requires careful assessment in an interdisciplinary setting.
RCT Entities:
BACKGROUND:Patients with antiplatelet and antithrombotic therapy (AP/AT) represent a substantial proportion of ear, nose and throat (ENT) patients. Despite the ubiquitous consideration of bleeding and ischemic/thrombembolic risk, no detailed assessment of the perioperative setting in an ENT cohort is available in the literature. OBJECTIVES: The goal of the present work is to give a detailed assessment of patients with AP/AT in an ENT cohort resulting in ENT-specific recommendations for daily routine. MATERIALS AND METHODS: In all, 400 randomized patients were asked regarding analgetic therapy in acute pain. Medical data of 5211 patients who underwent head and neck surgery were analyzed for AP/AT therapy. Therapeutic strategies, the perioperative AP/AT therapy, duration of intensive care treatment and hospitalization (ICT/H), application of erythrocytes and internistic/neurolocigal complication data were analyzed in patients with/without AP/AT. RESULTS: Nearly 75 % of our patients were taking AP/AT due to coronary heart disease (CHD), peripheral arterial disease (PAD), cardiac arrhythmia, or cardiovascular disease (CVD). Patients' questionnaire revealed that 31 % of our patients use acetylsalicylic acid in acute pain, which represents 10 % of the overall AP/AT cohort. Head and neck surgery in patients with AP/AT showed an elevated bleeding frequency (p = 0.006) without an elevated risk for internistic/neurological complications. ICT/H were remarkably prolonged (p = 0.006; p = 0.0004). DISCUSSION: Head and neck surgery in patients with AP/AT can be routinely performed. Indication for intensive care, endotracheal intubation, and tracheostomy should be made generously due to high requirements of airway management in ENT. Ischemic/thrombembolic and bleeding risk requires careful assessment in an interdisciplinary setting.
Authors: Ian Graham; Dan Atar; Knut Borch-Johnsen; Gudrun Boysen; Gunilla Burell; Renata Cifkova; Jean Dallongeville; Guy De Backer; Shah Ebrahim; Bjørn Gjelsvik; Christoph Herrmann-Lingen; Arno Hoes; Steve Humphries; Mike Knapton; Joep Perk; Silvia G Priori; Kalevi Pyorala; Zeljko Reiner; Luis Ruilope; Susana Sans-Menendez; Wilma Scholte Op Reimer; Peter Weissberg; David Wood; John Yarnell; Jose Luis Zamorano; Edmond Walma; Tony Fitzgerald; Marie Therese Cooney; Alexandra Dudina; Alex Vahanian; John Camm; Raffaele De Caterina; Veronica Dean; Kenneth Dickstein; Christian Funck-Brentano; Gerasimos Filippatos; Irene Hellemans; Steen Dalby Kristensen; Keith McGregor; Udo Sechtem; Sigmund Silber; Michal Tendera; Petr Widimsky; Jóse Luis Zamorano; Attila Altiner; Enzo Bonora; Paul N Durrington; Robert Fagard; Simona Giampaoli; Harry Hemingway; Jan Hakansson; Sverre Erik Kjeldsen; Mogens Lytken Larsen; Giuseppe Mancia; Athanasios J Manolis; Kristina Orth-Gomer; Terje Pedersen; Mike Rayner; Lars Ryden; Mario Sammut; Neil Schneiderman; Anton F Stalenhoef; Lale Tokgözoglu; Olov Wiklund; Antonis Zampelas Journal: Eur J Cardiovasc Prev Rehabil Date: 2007-09
Authors: A John Camm; Gregory Y H Lip; Raffaele De Caterina; Irene Savelieva; Dan Atar; Stefan H Hohnloser; Gerhard Hindricks; Paulus Kirchhof Journal: Europace Date: 2012-08-24 Impact factor: 5.214
Authors: Deborah Siegal; Jovana Yudin; Scott Kaatz; James D Douketis; Wendy Lim; Alex C Spyropoulos Journal: Circulation Date: 2012-08-21 Impact factor: 29.690
Authors: Alec Vahanian; Ottavio Alfieri; Felicita Andreotti; Manuel J Antunes; Gonzalo Barón-Esquivias; Helmut Baumgartner; Michael Andrew Borger; Thierry P Carrel; Michele De Bonis; Arturo Evangelista; Volkmar Falk; Bernard Lung; Patrizio Lancellotti; Luc Pierard; Susanna Price; Hans-Joachim Schäfers; Gerhard Schuler; Janina Stepinska; Karl Swedberg; Johanna Takkenberg; Ulrich Otto Von Oppell; Stephan Windecker; Jose Luis Zamorano; Marian Zembala Journal: Eur J Cardiothorac Surg Date: 2012-08-25 Impact factor: 4.191
Authors: Axel Schlitt; Csilla Jámbor; Michael Spannagl; Wiebke Gogarten; Tom Schilling; Bernhard Zwissler Journal: Dtsch Arztebl Int Date: 2013-08-05 Impact factor: 5.594
Authors: Mathew K Marsee; Faisal S Shariff; Grant Wiarda; Patrick J Watson; Ali H Sualeh; Toby J Brenner; Max L McCoy; Hamid D Al-Fadhl; Alexander J Jones; Patrick K Davis; David Zimmer; Craig Folsom Journal: J Clin Med Date: 2022-02-20 Impact factor: 4.241