A Multicenter Propensity Score-Matched Cohort Study of Preoperative Antiplatelet Therapy and Postoperative Outcomes in Elderly Surgical Patients
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background and Objectives: Elderly patients frequently receive antiplatelet therapy, creating a clinical dilemma between bleeding risk and cardiovascular protection during surgery. We evaluated the association between preoperative antiplatelet therapy and postoperative bleeding and cardiovascular events using multicenter observational data. Materials and Methods: We conducted a retrospective cohort study using standardized OMOP-CDM databases from 10 tertiary hospitals. Patients aged ≥65 years undergoing surgery were classified by preoperative aspirin or clopidogrel exposure. Propensity score matching was performed within each site. Hazard ratios (HRs) were estimated using Cox regression and pooled using meta-analytic techniques. Results: A total of 1464 exposed patients and 7038 matched comparators were analyzed. Across sites, hazard ratios varied without a statistically significant pooled association. The pooled HR for postoperative events was 1.01 (95% CI 0.57–1.78, p = 0.967). Covariate balance improved substantially after matching. Conclusions: Preoperative antiplatelet therapy was not associated with a consistent increase in postoperative bleeding or cardiovascular events in elderly surgical patients. These findings support individualized perioperative management rather than routine discontinuation.
Source: Medicina
Authors: Seokyoung Song, Hyungseok Seo, Il Seok Kim, Minsoo Kim, Lim Youn Hee, Jung Eun Kim, Soo Il Choi, Dong Hyuck Kim, Young Hun Lee, Moonki Park, Jong Bum Choi, Cheolhyeong Lee, Seung Hee Yoo, Ho Kyung Yu, Chan Noh, Seong Young Choi, Sang Gyu Kwak
Institutions: Daegu Catholic University, Daegu Catholic University Medical Center, Kyung Hee University Hospital at Gangdong, Hallym University, Kangdong Sacred Heart Hospital, Kangwon National University, Kangwon National University Hospital, Gyeongsang National University, Gyeongsang National University Hospital, Kyung Hee University, Kyung Hee University Medical Center, Catholic Kwandong University International St. Mary's Hospital, Myongji Hospital, Ajou University Hospital, Ajou University Medical Center, Wonkwang University, Ewha Womans University, Ewha Womans University Mokdong Hospital, Gyeongsang National University Changwon Hospital, Chungnam National University
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,654
OpenAlex ID: W7135015642