Introduction Thoracentesis is one of the most commonly performed procedures in the inpatient setting. Although coagulation profile is usually evaluated prior to thoracentesis, bleeding is a rare complication, occurring in less than 1% of the cases. Several society guidelines recommend holding antiplatelet medications and anticoagulants prior to thoracentesis. Clinical practice guidelines also recommend correcting international normalised ratios of more than two and platelet counts <50 X10∧9/L. Methods This is a retrospective descriptive study that included 292 patients who underwent thoracentesis in the inpatient setting at Ascension St John Hospital in Detroit, Michigan, USA from 2016 to 2018. We identified patients who had uncorrected risk for bleeding and collected data about their demographics, comorbidities, use of antiplatelet or anticoagulants and procedural details including complications. We looked for any postprocedural bleeding events to study their relation to the already established bleeding risk. Results Two hundred and ninety-two thoracenteses were performed, 95.5% (n=279) were performed by interventional radiology. Majority of patients were at risk of bleeding 83% (n=242). No bleeding events occurred. Medications that were not held prior to thoracentesis included: clopidogrel 11% (n=32), novel anticoagulants 8.2% (n=24) and unfractionated heparin 50% (n=146). Use of ultrasound guidance decreased the amount of haemoglobin decline from 1 to 2 g/L (p=0.029). Seventeen patients suffered pneumothorax, eight of which required intervention. Discussion Our study suggests that performing thoracentesis without correction of underlying coagulopathy may be safe. This may prevent consequences of holding essential medications and reduce the amount of blood products administered to patients in need of thoracentesis. No data are available. N/A.

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接受不同抗凝剂和抗血小板治疗的患者进行胸腔穿刺术的出血发生率

简介 胸腔穿刺术是住院环境中最常进行的手术之一。尽管通常在胸腔穿刺术之前评估凝血状况，但出血是一种罕见的并发症，发生率不到 1%。一些社会指南建议在胸腔穿刺术前服用抗血小板药物和抗凝剂。临床实践指南还建议纠正大于 2 的国际标准化比率和血小板计数 <50 X10∧9/L。方法 这是一项回顾性描述性研究，包括 292 名患者，这些患者于 2016 年至 2018 年在美国密歇根州底特律的 Ascension St John 医院的住院环境中接受了胸腔穿刺术。合并症，抗血小板或抗凝剂的使用以及包括并发症在内的手术细节。我们寻找任何术后出血事件来研究它们与已经确定的出血风险的关系。结果 实施胸腔穿刺术292例，介入放射学占95.5%（n=279）。大多数患者有 83% (n=242) 的出血风险。没有发生出血事件。胸腔穿刺术前未服用的药物包括：氯吡格雷 11% (n=32)、新型抗凝剂 8.2% (n=24) 和普通肝素 50% (n=146)。使用超声引导将血红蛋白下降量从 1 g/L 降低到 2 g/L (p=0.029)。17 名患者出现气胸，其中 8 名需要干预。讨论 我们的研究表明，在不纠正潜在凝血功能障碍的情况下进行胸腔穿刺术可能是安全的。这可以防止持有基本药物的后果，并减少给予需要胸腔穿刺术的患者的血液制品量。没有可用数据。不适用。