{
  "abstract": "Background Atrial fibrillation (AF) is a cardiac arrhythmia characterised by rapid, chaotic and uncoordinated atrial activity leading to subsequent deterioration in cardiac function. It is estimated that over 11% of people over the age of 80 in Ireland have AF. The aim of AF management focuses on symptom control and stroke prevention, using rate-controlling agents and anticoagulants. These medications can lead to various adverse events such as haemorrhages or falls, often necessitating urgent surgical intervention. Although there are set guidelines for the perioperative management of anticoagulation therapy outlined by the European Heart Rhythm Association, there remains clinical apprehension among physicians to stop anticoagulants in patients with atrial fibrillation prior to surgery. This is exacerbated by the fact that many AF patients have complicated medical histories with multiple comorbidities.Aim This study aimed to assess the impact of anticoagulation on perioperative care in our inpatient population with atrial fibrillationMethods We conducted a cross-sectional snapshot study of 100 inpatients over a 6-week period who had a diagnosis of atrial fibrillation. The primary outcomes included reason for admission, adverse side effects from anticoagulant use and surgical delays and issues because of anticoagulant use. Those under the care of cardiology or cardiothoracic surgery were excluded. Descriptive and inferential statistical analyses were performed on the collected data using SPSS version 30, with significance set at p < 0.05.Results 87% of patients were currently taking factor Xa inhibitors for their atrial fibrillation. Of those on medications for AF, 37% reported adverse side effects, mainly excessive bruising and inappropriate bleeding. 89% of the patient population had needed a surgery at some point, and 50% of the patients had been taking anticoagulants at the time of the surgery. Of the patients on anticoagulants at the time of surgery, 87.7% reported issues with the main issue being delays to surgical intervention because of their anticoagulation therapy. The main categories of surgical intervention required were general surgery (36%), orthopaedic surgery (18%) and cardiac (including cardiology procedures) (10%). Patients who had had a procedural intervention for their Afib were significantly more likely to have had issues with their surgery compared to those who had only ever been managed medically (79.2% vs. 40.8%, p<0.004).Conclusion In this patient cohort, anticoagulation therapy in patients with atrial fibrillation is associated with a substantial burden of perioperative challenges, particularly surgical delays. These findings highlight the need for improved perioperative anticoagulation planning and multidisciplinary coordination to minimise disruption to surgical care.",
  "authors": [
    {
      "affiliations": [
        "University of Galway, Galway, Ireland"
      ],
      "name": "Katie Scrivener"
    },
    {
      "affiliations": [
        "University Hospital Galway, Galway, Ireland"
      ],
      "name": "Alan Soo"
    }
  ],
  "title": "219 The impact of anticoagulation management in atrial fibrillation on perioperative care",
  "uid": "8349d370-8eb6-5d1a-ac78-704412490930"
}