Publication: Perioperative Anticoagulation and Risk Assessment: Building a Bridge Over a STREAM
| creativeworkseries.issn | JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X | |
| dc.contributor.author | Harrison, Anil | |
| dc.contributor.author | Rayamajhi, Sushil | |
| dc.date.accessioned | 2025-07-28T10:42:43Z | |
| dc.date.available | 2025-07-28T10:42:43Z | |
| dc.date.issued | 2025 | |
| dc.description | Anil Harrison Department of Medicine, Midwestern University, Glendale, Arizona, USA. Sushil Rayamajhi University of Central Florida College of Medicine/HCA Florida West Hospital, Pensacola, Florida, USA | |
| dc.description.abstract | Abstract Perioperative care requires a comprehensive assessment of the risks of bleeding and thrombosis. The 2022 CHEST Guidelines offer an empirical foundation for customized treatment using clinical judgment and risk assessment based on CHA2DS2-VASC and HAS-BLED scores. Despite the ease of access to anticoagulation guidelines, decision-making remains challenging, particularly when determining the necessity of bridging therapy with unfractionated or low-molecular-weight heparin. To facilitate this decision, we provide a mnemonic, STREAM, that highlights high-risk situations that require bridging. These include recent stroke or transient ischemic attack, severe thrombophilia, rheumatic valvular disease, recent venous thromboembolism, atrial fibrillation with high CHA2DS2-VASC scores, and mechanical heart valves. This mnemonic offers physicians a methodical approach to optimize perioperative anticoagulation control while minimizing the risk of hemorrhage and thrombosis. | |
| dc.identifier | https://doi.org/10.31729/jnma.8910 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.14572/868 | |
| dc.language.iso | en_US | |
| dc.publisher | Nepal Medical Association | |
| dc.title | Perioperative Anticoagulation and Risk Assessment: Building a Bridge Over a STREAM | |
| dc.type | Other | |
| dspace.entity.type | Publication | |
| local.article.type | Viewpoint | |
| oaire.citation.endPage | 201 | |
| oaire.citation.startPage | 199 | |
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