The effect of antithrombotic drugs on intraoperative operative blood loss volume in patients undergoing emergency surgery for generalized peritonitis is not well defined. The purpose of this study was to investigate the effect of antithrombotic drugs on intraoperative blood loss in patients with generalized peritonitis using a nationwide surgical registry in Japan. This retrospective cohort study used a nationwide surgical registry data from 2011 to 2017 in Japan. Propensity score matching for the use of antithrombotic drugs was used for the adjustment of age, gender, comorbidities, frailty, preoperative state, types of surgery, surgical approach, laboratory data, and others. The main outcome was intraoperative blood loss: comparison of intraoperative blood loss, ratio of intraoperative blood loss after adjusted for confounding factors, and variable importance of all covariates. A total of 70,105 of the eligible 75,666 patients were included in this study, and 2947 patients were taking antithrombotic drugs. Propensity score matching yielded 2864 well-balanced pairs. The blood loss volume was slightly higher in the antithrombotic drug group (100 [10–349] vs 70 [10–299] ml). After adjustment for confounding factors, the use of antithrombotic drugs was related to a 1.30-fold increase in intraoperative blood loss compared to non-use of antithrombotic drugs (95% CI, 1.16–1.45). The variable importance revealed that the effect of the use of antithrombotic drugs was minimal compared with surgical approach or type of surgery. This study shows that while taking antithrombotic drugs is associated with a slight increase in intraoperative blood loss in patients undergoing emergency surgery for generalized peritonitis, the effect is likely of minimal clinical significance.

中文翻译：

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抗血栓药物对全身性腹膜炎急诊手术术中失血量的影响很小：日本的一项全国性回顾性队列研究

抗血栓药物对全身性腹膜炎急诊手术患者术中失血量的影响尚不明确。本研究的目的是在日本全国范围的外科登记处调查抗血栓药物对全身性腹膜炎患者术中失血量的影响。这项回顾性队列研究使用了日本 2011 年至 2017 年的全国外科登记数据。使用抗血栓药物的倾向评分匹配用于调整年龄、性别、合并症、虚弱、术前状态、手术类型、手术方法、实验室数据等。主要结果是术中失血量：术中失血量比较，校正混杂因素后术中失血量比，和所有协变量的可变重要性。本研究共纳入符合条件的 75,666 名患者中的 70,105 名，其中 2947 名患者正在服用抗血栓药物。倾向得分匹配产生了 2864 个平衡良好的配对。抗血栓药物组的失血量略高（100 [10-349] 比 70 [10-299] ml）。调整混杂因素后，与不使用抗血栓药物相比，使用抗血栓药物导致术中失血增加 1.30 倍（95% CI，1.16-1.45）。可变重要性表明，与手术方法或手术类型相比，使用抗血栓药物的影响很小。