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. 2024 Oct:236:115856.
doi: 10.1016/j.amjsurg.2024.115856. Epub 2024 Jul 18.

Effect of antiplatelet and anticoagulant therapy on bleeding complications following ventral hernia repair: An ACHQC analysis

Benjamin L Reed  1 , Jeremy A Warren  1 , M Wes Love  1 , Brian D Hodgens  1 , William S Cobb  1 , Alfredo M Carbonell  2
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Effect of antiplatelet and anticoagulant therapy on bleeding complications following ventral hernia repair: An ACHQC analysis

Benjamin L Reed et al. Am J Surg. 2024 Oct.

Abstract

Background: We investigate the effect of antiplatelet and anticoagulant medications on bleeding complications in patients undergoing ventral hernia repair.

Methods: The Abdominal Core Health Quality Collaborative registry was queried from 2013 to 2022 for patients who underwent ventral hernia repair, evaluating the association between antiplatelet or anticoagulant use and bleeding complications.

Results: 37,973 patients underwent ventral hernia repair: 11.5 ​% on antiplatelet therapy alone and 5.8 ​% on anticoagulation alone. Despite being held, an adjusted regression analysis showed that anticoagulation was associated with an increased risk for postoperative bleeding requiring transfusion (OR 2.4 [1.7-3.4], p ​< ​0.0001), reoperation for postoperative bleeding (OR 6.3 [3.9-10.0], p ​< ​0.0001), and readmission for bleeding complications (OR 4.9 [2.9-8.2], p ​< ​0.0001). Antiplatelet use was not a risk factor for any postoperative bleeding complication.

Conclusion: Despite being held preoperatively, patients on anticoagulants are at an increased risk for postoperative hemorrhagic complications. Antiplatelet therapy does not pose the same risk.

Keywords: Anticoagulation; Antiplatelet; Hernia repair; Perioperative anticoagulation; Ventral hernia.

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Conflict of interest statement

Declaration of competing interest Drs. Warren and Carbonell have received honoraria from Intuitive for consulting/speaking. Dr. Warren has also received honoraria from Johnson & Johnson/Ethicon for consulting/speaking. Dr. Cobb has received honoraria from W.L. Gore for consulting/speaking. The authors used generative AI (ChatGPT) to improve readability and language in this manuscript. The manuscript was read, revised, and approved by all authors after the insertion of AI generated text. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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