The effects of previous acetylsalicylic acid therapy on the platelet aggregation and postoperative outcome in vascular patients after elective surgical procedures

Cilj: Utvrditi kako ASK utječe na agregaciju trombocita i ishod elektivnih operacija kod vaskularnih bolesnika. Materijal i metode: U ovom retrospektivnom istraživanju, analizirane su povijesti bolesti i anesteziološke liste 114 vaskularnih bolesnika operiranih od 15. listopada 2009. do 07. svibnja 2016. Od svih operiranih bolesnika njih 72 bilo je na terapiji acetilsalicilnom kiselinom (ASK), a za 42 bolesnika nije bilo podataka o uzimanju ASK-a. U ispitanim skupinama uspoređeni su opći podatci, operacijski pokazatelji, akutni infarkt miokarda i smrtnost. Svi podatci analizirani su uporabom t-testa i χ2 ili Fisherova egzaktnog testa. Rezultati: Ispitanici se nisu razlikovali prema spolu i dobi. Od 72 bolesnika u skupini ASK bilo je 54 muškaraca i 18 žena, a u skupini bez ASK 28 muškaraca i 14 žena. Raspon dobi ispitanika u skupini ASK kretao se od 37 do 80 godina, a u skupini bez ASK od 51 do 79. Prosječna vrijednost (aritmetička sredina) agregacije trombocita u skupini ASK iznosila je 53,5, a u skupini bez ASK 66,4. U obje skupine zabilježen je jedan smrtni ishod. U skupini ASK zabilježeno je šest hematoma, a u skupini bez ASK niti jedan. Zbog maloga broja ispitanika razlike između dviju promatranih skupina bolesnika nisu bile statistički značajne. Zaključak: Istraživanje je potvrdilo pretpostavku da će vrijednosti agregacije trombocita u ispitanika koji su uzimali ASK biti unutar referentnog raspona te da ASK nije potrebno ukidati prije operacije. Međutim, zbog rizika pojave hematoma kod tih bolesnika potreban je povećan oprez i pažljiva hemostaza te pojačan poslijeoperacijski nadzor.Aims of the study. To determine how acetylsalicylic acid affects platelet aggregation and outcome of the vascular surgery. Material and methods: In the retrospective study 114 medical records and anesthesia charts of patients undergoing vascular surgery in the period from 2009 to 2016 year were analyzed. A total of 72 patients were treated with acetylsalicylic acid and 42 patients did not have data about taking it. Demographic data, operative parameters, frequency of complications such as acute myocardial infarction and mortality were compared with the outcome of vascular surgeries for patients who do not take acetylsalicylic acid. All data were entered and analyzed using t-test and χ2 or Fisher exact test. Results: Demographic data were not different between groups. There were 54 male and 18 female patients in group taking acetylsalicylic acid and 28 male and 14 female patients in group without anti-aggregation therapy. The age of the patients ranged from 37 to 80 years in the first group. In the second group, age range was from 51 to 79 years. The average value of platelet aggregation in the first group was 53.5. The average value in the second group was 66.4. The research confirmed the assumption that the value of platelet aggregation of patients taking aspirin will be within the normal range. One death occurred in both groups and six postoperative hematomas were registered only in the acetylsalicylic acid group. Due to the small number of the patients, differences were not statistically significant. Conclusion: Platelet aggregation was within reference values in this study group. In line with current recommendations, acetylsalicylic acid must not be abolished prior to the surgery. Its’ use however, demands adequate hemostasis and careful postoperative monitoring of patients