Meta Analysis:the Efficacy And Risk Assessment Of Maintenance Of Aspirin With Patient Undergoing Non-cardiac Surgery

Objective:This systematic review compares the risk of major vascular thrombosis and postoperative bleeding complications in patients with non-cardiac surgery during perioperative maintenance or interrupt of aspirin therapy,providing evidence for clinical perioperative management of aspirin.Methods: Until December 31 st 2016,the relevant key words were used to retrieve in Cochrane controlled trials central registry(CENTRAL),Pubmed,EMBASE and Web of Science(WOS)databases.Randomized controlled clinical and retrospective cohort study were included.Inclusion criteria:1)The literature contains a comparison of whether aspirin treatment was performed during perioperative period in patients who underwent non-cardiac surgery.2)And major postoperative vascular thrombosis,bleeding complications,and average stay were reported in the literature.Exclusion criteria:1)The study was not established in the control group or the control group was different from this study;2)There were defects or problems in study designs or methods on the literature;3)The animal research was not taken into consideration;4)The non English literature was excluded;5)Repeated literature and the literature whose original data can not be obtained such as review,lectures,comment,etc.To reduce the selection bias and hybrid bias in retrospective cohort studies,we performed meta-analysis of 15 studies and meta-analysis of three RCT studies independently.The main measures of this system review include: the number of major postoperative vascular embolism,the number of postoperative bleeding complications and the average length of stay.Result:The systematic review included 15 studies,12 retrospective cohort studies(2323 patients)and 3 RCT studies(563 patients).Analysis of postoperative major vascular thrombosis events: 14 meta-analysis of the studies showed that RR combined = 0.59,P <0.05;and three RCT independent studies showed RR combined = 0.48,P = 0.08.So the difference between the two groups has no statistical significance.Analysis results of postoperative bleeding complications: the meta-analysis results of 15 studies and 3 RCT studies were P = 0.22 and p = 0.54,that is,the difference between the two groups was not statistically significant.The average hospital stay was MD combined =-0.05,P = 0.76,so,the difference in mean hospitalization between the two groups was not statistically significant.Conclusion:Maintenance of aspirin therapy may reduce the risk of perioperative major vascular thrombosis for patients with long-term aspirin anti-platelet therapy in non-cardiac surgery.Also,more RCT studies are needed to conform this conclusion.And the study found that maintenance of aspirin treatment does not increase the risk of perioperative bleeding complications.There was no difference in the length of stay between the two groups.