Transcription of Perioperative Anticoagulation Algorithm
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Perioperative Anticoagulation Algorithm
SCHS Anticoagulation Guidelines 1 Perioperative Anticoagulation GUIDELINE/DOAC management Options for Anticoagulation continue to expand with the use of direct oral anticoagulants (DOACs). While the thromboembolic risk is determined by the patient s condition, the Perioperative management of DOACs is vastly different and varied. Bridging is not recommended with DOACs. DOAC Patient is Taking Surgery Bleeding Risk Preoperative DOAC Interruption Schedule Postoperative DOAC Resumption Schedule Day -5 Day -4 Day -3 Day -2 Day -1 Day +1 Day + 2 Day +3 Day +4 Apixaban (Eliquis) Mod/High X X X Low X Dabigatran (CrCl>50ml/min) Mod/High X X X Low X Dabigatran (CrCl<50ml/min) Mod/High X X X X X Low X X Rivaroxaban (Xarelto) Mod/High X X X Low X For patients undergoing neuraxial anesthesia, hold DOAC 72 hours prior to procedure.
Douketis JD, et al. The Perioperative Management of Antithrombotic Therapy. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines 8th ed. CHEST 2008: 133 (6): 299s-339s. Douketis JD, et al. Perioperative Management of Antithrombotic Therapy, 9th ed. American College of Chest Physicians- Evidence Based Practice
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