Risk-adjusted perioperative bridging anticoagulation reduces bleeding complications without increasing thromboembolic events in general and visceral surgery

Table 2 Changes in perioperative bridging

Characteristic, n (%)	Period 1 n = 263	Period 2 n = 271	p value
Bridging
full-dose LMWH¹	189 (72)	92 (34)	< 0.001
half-dose LMWH¹	26 (10)	64 (24)	< 0.001
too aggressive²	160 (60.8)	89 (32.8)	< 0.001
despite DOAC³	18 (78.2)	79 (54.8)	0.034
Preoperative interruption of anticoagulation ≥ 24 hours⁴	107 (41)	214 (79)	< 0.001
Normal thrombosis prophylaxis⁵	48 (18)	70 (26)	< 0.001
No perioperative LMWH application	0	27 (10)	< 0.001
Restart of OAC before discharge	3 (1.1)	86 (32)	< 0.001

¹LMWH, low molecular weight heparin
²Defined as full-dose LMWH in patients at low or moderate risk of thromboembolism
³DOAC, direct oral anticoagulants. Peri-interventional bridging is not recommended in the medicinal products information of those drugs
⁴Including preoperative LMWH bridging or DOAC application
⁵Normal prophylactic dose of LMWH as for general patients undergoing surgery

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