Complications of cutaneous surgery in patients taking clopidogrel-containing anticoagulation.
J Am Acad Dermatol
; 65(3): 584-591, 2011 Sep.
Article
em En
| MEDLINE
| ID: mdl-21514003
ABSTRACT
BACKGROUND:
Most anticoagulants are not associated with increased risk of severe complications during cutaneous surgery, but no data exist on clopidogrel.OBJECTIVE:
We sought to determine frequency and severity of perioperative complications in patients taking clopidogrel-containing anticoagulation.METHODS:
This was a retrospective review of medical records of patients undergoing Mohs micrographic surgery at Mayo Clinic, Rochester, MN, while taking clopidogrel-containing anticoagulation between 2004 and 2008, compared with control subjects taking aspirin monotherapy or no anticoagulants.RESULTS:
In all, 220 patients taking clopidogrel-containing anticoagulation underwent 363 surgical procedures on 268 occasions. Severe complications occurred in 11 of 363 surgical sites in 10 cases. Clopidogrel-containing anticoagulation was 28 times more likely than no anticoagulation and 6 times more likely than aspirin monotherapy to result in severe complications after Mohs procedures (P < .001 and P = .022, respectively). Severe complications were 8 times more likely after Mohs procedures in patients taking both clopidogrel and aspirin than in control subjects taking aspirin monotherapy (P = .009). No statistically significant difference was found between patients taking clopidogrel monotherapy and control subjects not taking anticoagulants (P = .15). Patients experiencing severe complications were more likely to have larger postoperative surgical sites (P < .001). No thrombotic complications were encountered with discontinuation of clopidogrel-containing anticoagulation; a postoperative thrombotic complication occurred in one patient whose clopidogrel-containing anticoagulation regimen was modified.LIMITATIONS:
Retrospective nature of study, possible recall bias as a result of telephone contact, and small number of severe complications were limitations, which reduced study power.CONCLUSION:
Cutaneous surgery in patients taking clopidogrel-containing anticoagulation is associated with an increased risk of nonlife-threatening severe complications.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Ticlopidina
/
Inibidores da Agregação Plaquetária
/
Procedimentos Cirúrgicos Dermatológicos
/
Anticoagulantes
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article