Cessation of XXXX before major abdominal procedures.

@entity1 @entity548 @entity1397 @entity260 @entity86 @entity204
OBJECTIVE: To determine whether timing of @entity1397 cessation influences outcome after abdominal operations. METHODS: A review was performed of 104 @entity1 receiving @entity1397 who underwent abdominal operations between March 2003 and March 2009. @entity1 were grouped by last @entity1397 use: group A (<7 days) and group B (>= 7 days). RESULTS: Of 104 @entity1 , 43 were in group A and 61 were in group B. Overall, 6 @entity204 occurred (group A, 5 @entity1 [12%] vs group B, 1 [2%]; P  =  .03) and 27 @entity1 required intensive care unit admission (group A, 16 @entity1 [37%] vs group B, 11 [18%]; P  =  .03). Twenty-one @entity1 developed a @entity260 ; 19 complications were managed by blood transfusion and 2 required reoperation. Group A vs group B had significantly increased rates of @entity86 requiring blood transfusion (13 @entity1 [30%] vs 8 [13%]; P  =  .03). No significant difference in @entity86 resulting in reoperation or mortality was demonstrated. Timing of @entity1397 cessation within 7 days did not affect @entity86 risk. Eighty-nine @entity1 (86%) underwent elective operations (group A, 30 @entity1 [70%] vs group B, 59 [97%]; P  <  .001). While elective @entity1 in group A vs those in group B demonstrated a trend toward increased risk of @entity86 requiring transfusion (7 @entity1 [23%] vs 8 [14%]; P  =  .25), no significant difference in intensive care unit admission (group A, 6 @entity1 [20%] vs group B, 9 [15%]; P  =  .31) or mortality (1 [3%] vs 1 [2%]; P  =  .62) was demonstrated. CONCLUSIONS: While @entity1397 use within 7 days of an operation significantly increased the risk of @entity86 , most @entity548 episodes were successfully managed by transfusion without an increase in @entity548 -related mortality or necessity for reoperation. After controlling for operative urgency, no significant difference in mortality or intensive care unit admission was demonstrated in @entity1 undergoing elective procedures. High-risk @entity1 undergoing elective operations may not require preoperative @entity1397 cessation. When @entity1397 cessation is warranted, 7 days before the procedure is recommended. Perioperative risk does not vary by timing of cessation within 7 days of an operation.
