ArticleAnnals of surgical oncology2016
Antiplatelet and Anticoagulant Medications Significantly Increase the Risk of Postoperative Hematoma: Review of over 4500 Thyroid and Parathyroid Procedures.
Article in Annals of surgical oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04852406 (Effect of Protocol-based Management on Perioperative Outcomes in Patients With Chronic Antithrombotic Therapy), which is not on this map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Protocol-based Management on Perioperative Outcomes in Patients With Chronic Antithrombotic Therapy: a Pragmatic Interventional Study
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy: a systematic review and meta-analysis.BMC surgery · 2019Pooled it
- Surgical Timing in Thyroid Cancer with Lateral Neck Metastases: Delayed Versus Contemporary Lateral Neck Dissection.Cancers · 2025Article
- Risk of Neck Hematoma Following Thyroidectomy in Patients Taking Direct Oral Anticoagulants: A Propensity Score Matching Analysis from Nine High-Volume European Centers (RAGNO Study).Journal of clinical medicine · 2025Article
- Evaluation of Hematoma Formation after Thyroidectomy Surgery and Its Related Factors.World journal of plastic surgery · 2024Article
- Thresholds for surgical referral in primary hyperparathyroidism: A conjoint analysis.American journal of surgery · 2023Article
- Review
- Surgery for primary hyperparathyroidism in Germany, Switzerland, and Austria: an analysis of data from the EUROCRINE registry.Langenbeck's archives of surgery · 2023Article
- Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study).Frontiers in surgery · 2023Article
- Surgical tips and techniques to avoid complications of thyroid surgery.Innovative surgical sciences · 2022Review
- Aspirin does not affect hematoma growth in severe spontaneous intracranial hematoma.Neurosurgical review · 2022Article
- Thyroidectomy for Graves' Disease Predicts Postoperative Neck Hematoma and Hypocalcemia: A North American cohort study.The Annals of otology, rhinology, and laryngology · 2022Article
- A cervical compartment syndrome impairs cerebral circulation in post-thyroidectomy hemorrhage: data from an animal model.Gland surgery · 2022Article
- Does the continuation of low-dose acetylsalicylic acid during the perioperative period of thyroidectomy increase the risk of cervical haematoma? A 1-year experience of two Italian centers.Frontiers in surgery · 2022Article
- The Effect of Preoperative Antiplatelet Therapy on Early Postoperative Rehemorrhage and Outcomes in Patients With Spontaneous Intracranial Hematoma.Frontiers in aging neuroscience · 2021Article
- Energy vessel sealant devices are associated with decreased risk of neck hematoma after thyroid surgery.Updates in surgery · 2020Article
- Letter to the Editor: Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management.World journal of surgery · 2020Article
- Management of Antithrombotic Agents During Surgery or Other Kinds of Medical Procedures With Bleeding: The MARK Study.Journal of the American Heart Association · 2020Observational
- Effectiveness of hemostatic agents in thyroid surgery for the prevention of postoperative bleeding.Scientific reports · 2020Article
- Does coagulopathy, anticoagulant or antithrombotic therapy matter in incisional hernia repair? Data from the Herniamed Registry.Surgical endoscopy · 2018Article
- Risk factors for postoperative haemorrhage after total thyroidectomy: clinical results based on 2,678 patients.Scientific reports · 2017Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeAntiplatelet and/or anticoagulant medication use is common. Abstinence a week before surgery may still result in altered hemostasis. The study aim was to report on perioperative antiplatelet and anticoagulant use in thyroidectomy and parathyroidectomy patients, and to determine the association with postoperative hematoma (POH) rates.
methodsRetrospective review of a prospective endocrine surgery database was performed. Procedure extent was defined as unilateral, bilateral, or extensive. Antiplatelets were categorized as none, 325 mg aspirin (ASA), <325 mg ASA, clopidogrel, or other. Anticoagulants were categorized as none, oral, or injectable.
resultsA total of 4514 patients were identified. POH developed in 22 patients (0.5 %). Rates were similar between age, gender, and reoperative status. POH were seven times more common after thyroidectomy (0.8 vs. 0.1 %, p < 0.01). Unilateral procedures had lower POH rates than bilateral or extensive (0.1 vs. 0.9 vs. 0.8 %, p < 0.01). POH rates in patients receiving 325 mg ASA (0.8 %) or clopidogrel (2.2 %) were much higher than patients not receiving antiplatelets (0.5 %) or receiving <325 mg ASA (0.1 %, p = 0.04). Oral anticoagulants (2.2 %) and injectable anticoagulants (10.7 %) had much higher POH rates than patients not receiving anticoagulants (0.4 %, p < 0.01). Target organ, patient gender, procedure extent, antiplatelet use, and anticoagulant use were included on logistic regression to determine association with POH. Bilateral procedures, thyroidectomy, clopidogrel, oral, and injectable anticoagulants were all independently associated with POH.
conclusionsPOH occur more frequently after thyroidectomy and during bilateral procedures. Patients requiring clopidogrel or any anticoagulant coverage are at much higher risk for POH. These higher-risk patients should be considered for observation to ensure prompt POH recognition and intervention.
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