Hemostatic prophylaxis and colonoscopy outcomes for patients with bleeding disorders: A retrospective cohort study and review of the literature

Haemophilia : the Official Journal of the World Federation of Hemophilia
Sarah M AzerRajiv K Pruthi

Abstract

Hemostatic prophylaxis (HP) is recommended for patients with bleeding disorders (PWBD) before invasive procedures. However, evidence-based guidelines are needed to determine optimal HP strategies. To determine outcomes of HP for PWBD undergoing colonoscopy. We undertook a retrospective cohort study of HP and outcomes of colonoscopy procedures performed between 9 November 1993 and 13 February 2018 for PWBD who received care in the Mayo Clinic Comprehensive Hemophilia Treatment Center. During the study period, 73 PWBD (58 with milder phenotypes: haemophilia, von Willebrand disease [subtypes 1 and 2; II, VII and XI deficiency]) underwent 141 procedures. Preprocedural HP was given to 61%, and interventions were performed in 47%. Of the 39% without preprocedural HP, postprocedural HP was given for 11%. One major (0.7%; 6 days postprocedure despite HP) and 10 minor (7%) bleeding complications occurred, which tended to be in patients with severe disease and/or after excision of larger polyps. There was no significant difference in the rate of bleeding complications with or without preprocedural HP (8.1% vs 5.5%, respectively; P = .74, Fisher's exact test). The low bleeding rates in our cohort suggest that preprocedure HP may be withhe...Continue Reading

References

Aug 8, 2006·Journal of Thrombosis and Haemostasis : JTH·J E SadlerUNKNOWN Working Party on von Willebrand Disease Classification
Nov 3, 2009·Journal of Thrombosis and Haemostasis : JTH·S SchulmanUNKNOWN Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on T
Nov 6, 2009·Gastrointestinal Endoscopy·Michelle A AndersonJason A Dominitz
Oct 5, 2010·Gastrointestinal Endoscopy Clinics of North America·Cynthia W Ko, Jason A Dominitz
May 7, 2011·Endoscopy·C BoustièreUNKNOWN European Society of Gastrointestinal Endoscopy
Sep 29, 2011·Gastrointestinal Endoscopy·Deborah A FisherJason A Dominitz
May 29, 2012·Haemophilia : the Official Journal of the World Federation of Hemophilia·J AstermarkUNKNOWN Malignancy in Haemophilia Workshop Group
May 16, 2013·Haemophilia : the Official Journal of the World Federation of Hemophilia·V TintillierP Renom
May 31, 2018·CA: a Cancer Journal for Clinicians·Andrew M D WolfRobert A Smith
Feb 13, 2019·Haemophilia : the Official Journal of the World Federation of Hemophilia·Marcel TomaszewskiTalat Bessissow

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