P.117 慢性硬膜下血肿引流术后抗血小板和抗凝血药物的使用与预后:系统回顾和荟萃分析

E. Liu, A. Zhou, N Tilbury, J Su, A. Persad, J. Radic
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引用次数: 0

摘要

背景:慢性硬膜下血肿(CSDH)是一种常见的神经外科疾病,可通过手术清除治疗。很大一部分 CSDH 患者在基线时正在接受抗血小板或抗凝治疗,这可能会影响复发和术后血栓栓塞事件的风险:在 MEDLINE(1946 年至 2023 年 4 月 6 日)、Embase(1974 年至 2023 年 4 月 6 日)和 PubMed(截至 2023 年 4 月 6 日)中对 CSDH 术前使用抗血小板或抗凝疗法以及手术排空后的结果进行了检索。结果:我们的文献包括来自 42 项研究的 14410 例患者,其中抗血小板(AP)组 3218 例(22%),抗凝(AC)组 1731 例(12%),无抗血栓(NA)组 9537 例(66%)。AP 组的复发率明显高于 NA 组(OR = 1.21,95% CI = 1.04 至 1.40,P = 0.01)。AC 组的复发率也明显高于 NA 组(OR = 1.39,95% CI = 1.15 至 1.68,P = 0.0007)。然而,接受任何抗血栓治疗也与血栓栓塞事件显著增加有关(OR 5.41,95% CI 3.16 至 9.26,p < 0.00001)。结论与未接受抗血栓治疗的患者相比,接受抗血栓治疗的患者复发率和血栓栓塞风险都更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
P.117 Antiplatelet and anticoagulation use and outcomes following chronic subdural hematoma drainage: systematic review and meta-analysis
Background: Chronic subdural hematoma (CSDH) is a common neurosurgical condition which can be treated with surgical evacuation. A significant percentage of CSDH patients are on antiplatelet or anticoagulation therapy at baseline which may influence risk of recurrence and postoperative thromboembolic events Methods: A search was conducted in MEDLINE (1946 to April 6, 2023), Embase (1974 to April 6, 2023), and PubMed (up to April 6, 2023) on preoperative use of antiplatelet or anticoagulation therapy and outcomes following surgical evacuation of CSDH. Results: Our literature includes 14,410 patients ifrom 42 studies, with 3218 (22%) in the antiplatelet (AP) group, 1731(12%) in the anticoagulation (AC) group, and 9537 (66%) in the no antithrombotics (NA) group. The AP group had significantly higher recurrence compared to NA (OR = 1.21, 95% CI = 1.04 to 1.40, p = 0.01). The AC group also had significantly high recurrence compared to NA (OR = 1.39. 95% CI = 1.15 to 1.68, p = 0.0007). However, being on any antithrombotic therapy is also associated with significantly higher thromboembolic events (OR 5.41, 95% CI 3.16 to 9.26, p < 0.00001). Conclusions: Patients on antithrombotic therapy have both higher recurrence and higher thromboembolic risk compared to patients not on antithrombotic therapy.
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