ArticleJournal of thrombosis and thrombolysis2016
Preoperative INR and postoperative major bleeding and mortality: A retrospective cohort study.
Article in Journal of thrombosis and thrombolysis, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Preoperative Platelet and International Normalized Ratio Thresholds and Their Impact on Complications Following Revision Total Joint Arthroplasty.Arthroplasty today · 2026Article
- Beyond the Scalpel: EGFR Mutation Predicts Intraoperative Blood Loss and Transfusion Needs During Lung Cancer-derived Spinal Metastasis Surgery.Annals of surgical oncology · 2025Article
- Preoperative coagulation parameters predict postoperative bleeding after endovascular treatment of intracranial aneurysms: A retrospective cohort study.The Journal of international medical research · 2025Article
- Advancements in the Optimization of Surgical Timing in Elderly Patients with Hip Fractures: A Narrative Review and Future Perspectives.Clinical interventions in aging · 2025Review
- Effect of INR on Outcomes of Endovascular Treatment for Acute Vertebrobasilar Artery Occlusion.Translational stroke research · 2024Article
- A retrospective chart analysis with 5-year follow-up of early care for geriatric hip fracture patients: why we should continue talking about hip fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- The Relationship Between Preoperative International Normalized Ratio and Postoperative Major Bleeding in Total Shoulder Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- The influence of elevated international normalized ratio on complications following total shoulder arthroplasty.Shoulder & elbow · 2023Article
- Mildly elevated INR is associated with worse outcomes following mechanical thrombectomy for acute ischemic stroke.Journal of neurointerventional surgery · 2023Article
- Machine learning algorithms to predict intraoperative hemorrhage in surgical patients: a modeling study of real-world data in Shanghai, China.BMC medical informatics and decision making · 2023Article
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- Prognostic Value of an Integrated Coagulation Score in Ischemic Stroke After Endovascular Therapy: A retrospective case series.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Little research has been done on the current cut-off international normalized ratio (INR) value of 1.5 for patients undergoing surgery. The objectives of this study are to assess the association between INR and postoperative major bleeding and mortality in patients undergoing surgery and to identify an ideal pre-operative INR for surgical patients. We analyzed data from the American College of Surgeons' National Surgical Quality Improvement Program database between 2008 and 2011 (636,231 patients). The primary outcomes were major bleeding and mortality at 30 days postoperatively. Multivariate logistic regression analyses were carried out to assess these associations. Compared to an INR of <1, the adjusted odds ratio (aOR) for major bleeding was 1.22 (95 % CI 1.18-1.25) for INR 1-1.49, 1.48 (95 % CI 1.40-1.56) for INR 1.5-1.9, and 1.49 (95 % CI 1.39-1.60) for INR ≥2. The aOR for mortality at 30 days post-operation compared to INR of <1 was 1.51 (95 % CI 1.41-1.62), 2.31 (95 % CI 2.12-2.52), and 2.81 (95 % CI 2.56-3.10) for INR 1-1.49, 1.5-1.9, and ≥2, respectively. The ideal pre-operative INR value to predict an increased risk for major bleeding was 1.10 and 1.13 for mortality. In conclusion, preoperative INR is significantly and independently associated with postoperative major bleeding and mortality.
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