Skip to Main content Skip to Navigation
Journal articles

Antiplatelet Drugs and Risk of Bleeding After Bedside Pleural Procedures: A National Multicenter Cohort Study

Abstract : Background: The decision-making on antiplatelet drug withdrawal or continuation before performing a pleural procedure is based on the balance between the risk of bleeding associated with the antiplatelet therapy and the risk of arterial thrombosis due to its interruption. Knowledge on antiplatelet therapy-associated risk of bleeding after pleural procedures is lacking. Research question: Is the risk of bleeding associated with antiplatelet drugs increased in patients undergoing pleural procedures? Study design and methods: We conducted a French multicenter cohort study in 19 centers. The main outcome was the occurrence of bleeding, defined as hematoma, hemoptysis, or hemothorax, during the 24 h following a pleural procedure. Serious bleeding events were defined as bleeding requiring blood transfusion, respiratory support, endotracheal intubation, embolization, or surgery, or as death. Results: A total of 1,124 patients was included (men, 66%; median age, 62.6 ± 27.7 years), of whom 182 were receiving antiplatelet therapy and 942 were not. Fifteen patients experienced a bleeding event, including eight serious bleeding events. The 24-h incidence of bleeding was 3.23% (95% CI, 1.08%-5.91%) in the antiplatelet group and 0.96% (95% CI, 0.43%-1.60%) in the control group. The occurrence of bleeding events was significantly associated with antiplatelet therapy in univariate analysis (OR, 3.44; 95% CI, 1.14-9.66; P = .021) and multivariate analysis (OR, 4.13; 95% CI, 1.01-17.03; P = .044) after adjusting for demographic data and the main risk factors for bleeding. Likewise, antiplatelet therapy was significantly associated with serious bleeding in univariate analysis (OR, 8.61; 95% CI, 2.09-42.3; P = .003) and multivariate analysis (OR, 7.27; 95% CI, 1.18-56.1; P = .032) after adjusting for the number of risk factors for bleeding. Interpretation: Antiplatelet therapy was associated with an increased risk of post-pleural procedure bleeding and serious bleeding. Future guidelines should take into account these results for patient safety.
Document type :
Journal articles
Complete list of metadata

https://hal-univ-paris.archives-ouvertes.fr/hal-03257510
Contributor : Equipe Hal Université de Paris Connect in order to contact the contributor
Submitted on : Friday, June 11, 2021 - 8:37:16 AM
Last modification on : Tuesday, September 28, 2021 - 5:16:42 PM

Identifiers

Citation

Laurence Dangers, Jonathan Giovannelli, Gilles Mangiapan, Mikael Alves, Naïke Bigé, et al.. Antiplatelet Drugs and Risk of Bleeding After Bedside Pleural Procedures: A National Multicenter Cohort Study. Chest, American College of Chest Physicians, 2021, 159 (4), pp.1621-1629. ⟨10.1016/j.chest.2020.10.092⟩. ⟨hal-03257510⟩

Share

Metrics

Record views

42