Trial reportAmerican heart journal2018
Predictors of perioperative major bleeding in patients who interrupt warfarin for an elective surgery or procedure: Analysis of the BRIDGE trial.
Trial report in American heart journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06844227 (Perioperative Anticoagulant Use for Surgery Evaluation -Virtual Visit), which is not on this map. Cited by 14 papers, 3 of them syntheses 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.
Perioperative Anticoagulant Use for Surgery Evaluation -Virtual Visit (PAUSE-Virtual), a Simple Perioperative Anticoagulant Management Approach, Replacing a Resource-intensive In-person Doctor-patient Consultation, With a Simple Virtual Care Model That Will Provide a New Standard of Care for Patients on a Direct Oral Anticoagulant or Warfarin and Require Elective Surgery/Procedure.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias.The Cochrane database of systematic reviews · 2021Pooled it
- Is alteration in single drug anticoagulant/antiplatelet regimen necessary in patients who need minor oral surgery? A systematic review with meta-analysis.Clinical oral investigations · 2021Pooled it
- Safety and efficacy of tranexamic acid in minimizing perioperative bleeding in extrahepatic abdominal surgery: meta-analysis.BJS open · 2021Pooled it
- Perioperative Management of Anticoagulation in Patients With Mechanical Heart Valves.JAMA network open · 2026Article
- Postoperative venous thromboembolism following cesarean delivery: prevalence, pathophysiology, diagnosis, treatment, and prevention.American journal of obstetrics and gynecology · 2026Review
- Anticoagulation Stewardship to Bridge the Implementation Gap in Perioperative Anticoagulation Management.TH open : companion journal to thrombosis and haemostasis · 2024Review
- Review
- Predictors of Bleeding in the Perioperative Anticoagulant Use for Surgery Evaluation Study.Journal of the American Heart Association · 2020Article
- Effect of Direct Oral Anticoagulant, Patient, and Surgery Characteristics on Clinical Outcomes in the Perioperative Anticoagulation Use for Surgery Evaluation Study.TH open : companion journal to thrombosis and haemostasis · 2020Article
- Perioperative interruption of direct oral anticoagulants and vitamin K antagonists in patients with atrial fibrillation: A comparative analysis.Research and practice in thrombosis and haemostasis · 2020Article
- Application value of thromboelastography in perioperative clinical blood transfusion and its effect on the outcome of patient.Experimental and therapeutic medicine · 2019Article
- Management of two major postoperative bleeding complications after mandible reconstruction with fibula free flap in a patient under chronic warfarin treatment.Case reports in plastic surgery & hand surgery · 2019Article
- Accuracy of HAS-BLED and BleedMAP Scores in Predicting Postoperative Bleeding in Anticoagulated Patients Undergoing non-Cardiac Surgery.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
- Laparoscopic Ventral Hernia Repair Postoperative Complications in End Stage Renal Disease Patients.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe use of low-molecular weight heparin bridge therapy during warfarin interruption for elective surgery/procedures increases bleeding. Other predictors of bleeding in this setting are not well described.
methodsBRIDGE was a randomized, double-blind, placebo-controlled trial of bridge therapy with dalteparin 100 IU/kg twice daily in patients with atrial fibrillation requiring warfarin interruption. Bleeding outcomes were documented from the time of warfarin interruption until up to 37 days postprocedure. Multiple logistic regression and time-dependent hazard models were used to identify major bleeding predictors.
resultsWe analyzed 1,813 patients of whom 895 received bridging and 918 received placebo. Median patient age was 72.6 years, and 73.3% were male. Forty-one major bleeding events occurred at a median time of 7.0 days (interquartile range, 4.0-18.0 days) postprocedure. Bridge therapy was a baseline predictor of major bleeding (odds ratio [OR]=2.4, 95% CI: 1.2-4.8), as were a history of renal disease (OR=2.9, 95% CI: 1.4-6.0), and high-bleeding risk procedures (vs low-bleeding risk procedures) (OR=2.9, 95% CI: 1.4-5.9). Perioperative aspirin use (OR=3.6, 95% CI: 1.1-11.9) and postprocedure international normalized ratio >3.0 (OR=2.1, 95% CI: 1.5-3.1) were time-dependent predictors of major bleeding. Major bleeding was most common in the first 10 days compared with 11-37 days postprocedure (OR=3.5, 95% CI: 1.8-6.9).
conclusionsIn addition to bridge therapy, perioperative aspirin use, postprocedure international normalized ratio >3.0, a history of renal failure, and having a high-bleeding risk procedure increase the risk of major bleeding around the time of an elective surgery/procedure requiring warfarin interruption.
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