The Patient Needs Emergency Surgery and is Under Treatment with Non-vitamin K Antagonist Oral Anticoagulants: What Shall We Do?

Jorge Pereira and Luis Filipe Pinheiro

Department of General Surgery, Tondela-Viseu Hospital Centre, Portugal

^*Correspondance to: Jorge Pereira 

 PDF  Full Text DOI: 10.25107/2474-1647.1366

Abstract

Introduction: A characteristic feature of emergency surgery is its limitation in patient preparation. It is difficult, and often impossible, to eliminate certain patient-dependent factors to reduce the operative risk. The effects of certain drugs in use by the patient, such as anticoagulant drugs, may be important in this respect. Among these anticoagulant drugs are the non-vitamin K antagonist oral anticoagulants (NOACs).Methods: In preparation for a lecture presentation in the XVII European Congress of Trauma and Emergency Surgery (Vienna, April 2016), the authors performed an Internet search using the terms “NOAC,” “new oral anticoagulant,” “direct oral anticoagulant,” and “emergency surgery” to gather scientific evidence with which to establish a collection of suggestions for the management of patients under anticoagulation with NOACs in the emergency setting.Conclusion: Data on the management of patients in the emergency setting undergoing treatment with anticoagulants are scarce and mainly based on information regarding routine preoperative approaches. Therefore, more scientific evidence is needed to establish appropriate guidelines that favor patients and are easy for caregivers to understand. The one consensus throughout the literature is that the reversal of NOACs is to be carried out with the administration of PCC.

Keywords

Direct antithrombin; Factor Xa inhibitors; Coumarin; Emergency surgery; NOAC

Cite the article

Pereira J, Pinheiro LF. The Patient Needs Emergency Surgery and is Under Treatment with Non-vitamin K Antagonist Oral Anticoagulants: What Shall We Do? Clin Surg. 2017; 2: 1366.