Das perioperative Management von unfallverletzten Patienten unter oraler Antikoagulation ist weitgehend unproblematisch – unabhängig davon, ob Vitamin-K-Antagonisten oder direkte orale Antikoagulanzien eingesetzt werden. Im Grunde entscheidet der klinisch vertretbare Zeitabstand zwischen dem Unfallereignis und dem Eingriff über das für den Patienten beste präoperative Vorgehen. In der postoperativen Phase erleichtern die DOAK die Wiederaufnahme der Antikoagulation, Phasen der alternativen Antikoagulation oder Überbrückung sind praktisch ausschließlich Patienten mit VKA vorbehalten.

Um Patienten vor vermeidbaren Risiken durch Blutungen oder Thromboembolien zu bewahren, aber auch im Interesse der Kostenbewusstheit empfiehlt es sich, klinikinterne Standards für die perioperative Versorgung antikoagulierter Unfallverletzter zu etablieren.

Interessenkonflikt: keine angegeben.

Korrespondenzadresse

Prof. Dr. med. Ulrich J. Sachs

Zentrum für Transfusionsmedizin und Hämotherapie

Universitätsklinikum Marburg

Baldingerstraße

35043 Marburg

ulrich.sachs@staff.uni-marburg.de

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Fussnoten

1 Zentrum für Transfusionsmedizin und Hämotherapie, Marburg