The researchers assessed perioperative warfarin management and complications in patients requiring colonoscopy.
The findings of the study were published in the December issue of Diseases of the Colon and Rectum.
Some 109 cases of colonoscopies, performed on 94 patients requiring anticoagulation with warfarin, were retrospectively reviewed.
Patients stopped their warfarin 3 days before colonoscopy.
Coagulation profiles obtained just before the colonoscopy showed a median prothrombin time of 13.4 seconds, with a range of 11.1 to 29.1 (normal range, 10.9 to 13.0). The median international normalized ratio was 1.2, with a range of 0.9 to 2.6.
Patients restarted warfarin the day after the examination.
During the colonoscopies, 47% of the patients underwent either hot biopsy or snare polypectomy.
| Risk of complication was low in patients taking warfarin.
| Diseases of the Colon & Rectum |
One examination that included several biopsies was associated with a hemorrhagic complication (0.9%) requiring hospitalization and transfusion.
Subset analysis of the therapeutic (biopsy and snare polypectomy) group indicated a slightly higher complication rate (1.7%). The median international normalized ratio was 1.3 (range, 1.0 to 2.3) and median prothrombin time was 13.7 (range, 11.6 to 25.9).
Dr Stephania K. C. Timothy, of the Ochsner Clinic Foundation, New Orleans, said on behalf of fellow authors, "Patients taking warfarin for anticoagulation may safely undergo colonoscopy.
"The risk of hemorrhagic complications increases slightly with hot biopsy or snare procedures."
"Further studies are needed to refine guidelines for colonoscopy in the patient requiring anticoagulation," it was concluded.