Evidence map›Paper›PMID 31791254›Full record

ArticleBMC gastroenterology2019

Clinical impact of the perioperative management of oral anticoagulants in bleeding after colonic endoscopic mucosal resection.

Shoko Ono, Marin Ishikawa, Kana Matsuda, Momoko Tsuda, Keiko Yamamoto, Yuichi Shimizu, Naoya Sakamoto

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
1.6field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Guideline
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  7. [IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2024
    Review
  8. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Shoko OnoDivision of Endoscopy, Hokkaido University Hospital, Nishi-7, Kita-15, Kita-ku, Sapporo, 060-8638, Japan. onosho@med.hokudai.ac.jp.
Marin IshikawaDivision of Endoscopy, Hokkaido University Hospital, Nishi-7, Kita-15, Kita-ku, Sapporo, 060-8638, Japan.
Kana MatsudaDepartment of Gastroenterology, Graduate School of Medicine and Faculty of Medicine Hokkaido University, Sapporo, Japan.
Momoko TsudaDepartment of Gastroenterology, Graduate School of Medicine and Faculty of Medicine Hokkaido University, Sapporo, Japan.
Keiko YamamotoDivision of Endoscopy, Hokkaido University Hospital, Nishi-7, Kita-15, Kita-ku, Sapporo, 060-8638, Japan.
Yuichi ShimizuDivision of Endoscopy, Hokkaido University Hospital, Nishi-7, Kita-15, Kita-ku, Sapporo, 060-8638, Japan.
Naoya SakamotoDepartment of Gastroenterology, Graduate School of Medicine and Faculty of Medicine Hokkaido University, Sapporo, Japan.
Hokkaido University Hospital · JPHokkaido University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeparin bridging therapy (HBT) is indeed related to a high frequency of bleeding after endoscopic mucosal resection (EMR). In this study, our aim was to investigate clinical impact of management of oral anticoagulants without HBT in bleeding after colonic EMR.

methodsFrom data for patients who underwent consecutive colonic EMR, the relationships of patient factors and procedural factors with the risk of bleeding were analysed. Our management of antithrombotic agents was based on the shortest cessation as follows: the administration of warfarin was generally continued within the therapeutic range, and direct oral anticoagulants (DOACs) were not administered on the day of the procedure. We calculated bleeding risks after EMR in patients who used antithrombotic agents and evaluated whether perioperative management of anticoagulants without HBT was beneficial for bleeding.

resultsA total of 1734 polyps in 825 EMRs were analysed. Bleeding occurred in 4.0% of the patients and 1.9% of the polyps. The odds ratios for bleeding using multivariate logistic regression analysis were 3.67 in patients who used anticoagulants and 4.95 in patients who used both anticoagulants and antiplatelet agents. In patients with one-day skip of DOACs, bleeding occurred in 6.5% of the polyps, and there were no significant differences in bleeding risk between HBT and continuous warfarin or one-day skip DOACs.

conclusionsThe use of oral anticoagulants was related to bleeding after colonic EMR, and perioperative management of oral anticoagulants based on the shortest cessation without HBT would be clinically acceptable.

Indexed as

Endoscopic Mucosal ResectionAdministration, OralAgedAnticoagulantsColonic PolypsDrug Administration ScheduleFemaleFibrinolytic AgentsGastrointestinal HemorrhageHeparinHumansJapanMaleMiddle AgedPerioperative CarePlatelet Aggregation InhibitorsAnticoagulantsFibrinolytic AgentsHeparinPlatelet Aggregation InhibitorsWarfarinColon polypDirect oral anticoagulantEndoscopic mucosal resectionHeparin bridging therapyWarfarin

Identifiers

PMID31791254
PMCPMC6889536
OpenAlexW2990714993

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.