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Debate continues concerning the pros and cons of stopping warfarin before surgical procedures. Authors of this prospective, observational cohort study examined occurrences of thromboembolic and bleeding complications within 30 days of warfarin interruption before outpatient surgical procedures. They used data from 101 community-based practices that provide care for patients on warfarin.
The researchers identified 1293 episodes of warfarin interruption before outpatient surgical procedures (dental procedures, colonoscopy, ophthalmologic surgery, epidural injection, prostate and breast biopsy, and skin surgery) in 1024 patients. Low-molecular-weight heparin was substituted for the regular warfarin dose in 8.6% of episodes. Thromboembolic event…