Stopping warfarin therapy is unnecessary for hand surgery

Interruption of appropriate therapeutic warfarin therapy imposes a risk of morbidity and mortality on the patient. Strategies to reduce the risks of interruption impose relatively large costs in terms of prolonged hospital stay, medication and coagulation monitoring. We report a series of 47 consecu...

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Bibliographic Details
Published in:Journal of hand surgery, British volume British volume, 2004-06, Vol.29 (3), p.203-205
Main Authors: Wallace, D.L, Latimer, M.D, Belcher, H.J.C.R
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anticoagulants - administration & dosage
Atrial Fibrillation - drug therapy
Female
Hand - surgery
Heart Valve Prosthesis
Hematoma - etiology
Hematoma - therapy
Hemostasis
Humans
International Normalized Ratio
Male
Middle Aged
Postoperative Complications
Stroke - prevention & control
Thromboembolism - prevention & control
Tourniquets
Treatment Outcome
Warfarin - administration & dosage
warfarin, hand surgery, anticoagulants
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Summary:Interruption of appropriate therapeutic warfarin therapy imposes a risk of morbidity and mortality on the patient. Strategies to reduce the risks of interruption impose relatively large costs in terms of prolonged hospital stay, medication and coagulation monitoring. We report a series of 47 consecutive surgical episodes on the hands of 39 patients without interruption of therapeutic warfarin anticoagulation and with an INR of between 1.3 and 2.9. There was no difficulty with intraoperative haemostasis. Two patients had minor bleeding-related complications with no long-term sequelae. The authors conclude that interruption to warfarin therapy is unnecessary if the INR is less than 3.0 and therefore inappropriate for therapeutically anticoagulated patients undergoing hand surgery.
ISSN:0266-7681
1532-2211
DOI:10.1016/j.jhsb.2003.12.008