Antiagregantes plaquetários em perioperátorio de cirurgias não cardíacas e a tomada de decisão entre manter ou suspender

• Autor(a) principal: Borges, Juliana Maria Dantas Mendonça
• Data de Publicação: 2018
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: http://ri.ufs.br/jspui/handle/riufs/8896
• topic: Cirurgia; Infarto do miocárdio; Inibidores de agregação de plaquetas; Adult surgery; Schooling myocardial infarction; Inhibitors of platelet aggregation; CIENCIAS DA SAUDE

Antiplatelet agents in the perioperative period of non-cardiac surgeries and the decision making between maintaining or suspending.Juliana Maria Dantas Mendonça Borges.2018 INTRODUCTION: In daily clinical practice there is the dilemma between maintaining or suspending antiplatelet agents in the perioperative period of non-cardiac surgeries. OBJECTIVES: To describe the prescribing pattern of antiplatelet agents in the perioperative period of noncardiac surgeries. METHODS: A cross-sectional study was carried out from October 2014 to October 2016 in a hospital. The study-dependent variable was the divergent therapy recommendations of the guidelines of the Brazilian Society of Cardiology (SBC). The independent variables included some characteristics, those responsible for the management and the causes of non adherence to the guidelines. Variables were included in the multivariate model. The analysis was based on the odds ratio (OR) and its respective 95% confidence interval (CI), estimated by logistic regression with a significance level of 5%. RESULTS: The sample consisted of adult patients undergoing non-cardiac surgeries using aspirin or clopidogrel (n = 161). The prescription of these drugs was in disagreement with that recommended by the guidelines in 80.75% of the sample. Surgeons performed the largest number (n = 63) of disagreeing guidelines. After the multivariate analysis, it was observed that patients with a higher level of education (OR = 0.24; 95% CI 0.07-0.78) and those with a previous episode of acute myocardial infarction (MI) (OR = 0,18; 95% CI 0.04-0.95), are more likely to use the therapy in agreement. CONCLUSION: Positive association between the educational level of the patients or previous history of AMI with the use of ASA and clopidogrel in the perioperative period of noncardiac surgeries. However, the divergences in the conduct reinforce the need to define internal protocols.