Does chronic warfarin cause increased blood loss and transfusion during lumbar spinal surgery?
Patients on chronic anticoagulation therapy with warfarin who have their therapy stopped 7 days before surgery and have their INR normalized still demonstrated increased intraoperative blood loss and requirement for postoperative transfusion. Surgeons should be aware of the increased propensity of these patients to bleed despite adherence to protocols and should attempt to mitigate this risk.
Recent risk factor trends are worrying. Good quality data on the extent and determinants of NCDs are essential to respond the changing health needs of populations with burgeoning NCD epidemics.