Masataka Mori1, Koki Ibayashi2, Masatoshi Kanayama3, Masaru Takenaka3, Koji Kuroda3, Keiji Muramatsu4, Yoshihisa Fujino2, Shinya Matsuda4, Fumihiro Tanaka3. 1. Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu, 807, Japan. masataka-m@med.uoeh-u.ac.jp. 2. Department of Environmental Epidemiology, University of Occupational and Environmental Health, Kitakyushu, Japan. 3. Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu, 807, Japan. 4. Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan.
Abstract
PURPOSE: There is little evidence to demonstrate the impact of heparin bridging (HB) in major surgery. This study aimed to evaluate the benefits and risks of HB in lung cancer surgery by comparing HB and non-HB (NHB) groups. METHODS: We extracted patients who were taking an anticoagulant, were diagnosed with lung cancer, and underwent lung resection between April 2014 and March 2018 from a nationwide database in Japan. We compared the HB and NHB groups to determine the benefits and risks of HB. The proportion of postoperative thromboembolism and bleeding events between the HB and NHB groups was the primary outcome. We performed propensity score matching to remove any HB assignment bias. RESULTS: We selected 2416 patients, and among these, 1068 patients had HB and 1348 did not. Propensity score matching extracted 1500 patients: 750 with HB and 750 without HB. After matching, a Chi-square test showed no significant difference in the incidence of postoperative thromboembolism (1.5% vs 0.9%, p value = 0.343) and bleeding events (5.9% vs 4.0%, p value = 0.124) between the two groups. CONCLUSIONS: There was no significant difference in the incidence of postoperative thromboembolism and bleeding in the patients with and those without HB.
PURPOSE: There is little evidence to demonstrate the impact of heparin bridging (HB) in major surgery. This study aimed to evaluate the benefits and risks of HB in lung cancer surgery by comparing HB and non-HB (NHB) groups. METHODS: We extracted patients who were taking an anticoagulant, were diagnosed with lung cancer, and underwent lung resection between April 2014 and March 2018 from a nationwide database in Japan. We compared the HB and NHB groups to determine the benefits and risks of HB. The proportion of postoperative thromboembolism and bleeding events between the HB and NHB groups was the primary outcome. We performed propensity score matching to remove any HB assignment bias. RESULTS: We selected 2416 patients, and among these, 1068 patients had HB and 1348 did not. Propensity score matching extracted 1500 patients: 750 with HB and 750 without HB. After matching, a Chi-square test showed no significant difference in the incidence of postoperative thromboembolism (1.5% vs 0.9%, p value = 0.343) and bleeding events (5.9% vs 4.0%, p value = 0.124) between the two groups. CONCLUSIONS: There was no significant difference in the incidence of postoperative thromboembolism and bleeding in the patients with and those without HB.