Perioperative Management of Anticoagulant Therapy

Anticoagulant medications are commonly prescribed to patients in the United States for a number of medical problems. Interruptions in anticoagulation can result in severe adverse outcomes, including permanent disability and death, from arterial and venous thromboembolism. These medications can also be associated with serious perioperative bleeding events. In fact, both bleeding and thromboembolic risks are amplified in the periprocedural period. Many patients undergo routine and emergent procedures, thus it is critical for hospitalists, who are routinely asked to manage medically complex surgical patients, to understand the periprocedural management of anticoagulation. There are many nuances to consider: not all patients are at the same risk of thromboembolism, not all procedures are associated with the same risk of bleeding, and the indications for “reversal agents” are complex. This activity will guide the participant on the perioperative timing of anticoagulant interruption, the potential need for perioperative bridging anticoagulation, and address these nuances to better equip hospitalists for managing perioperative reversal.

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Availability

On-Demand

Expires on Oct 17, 2026

Cost

Member: $0.00

Non-Member: $95.00

Credit Offered

2 CME Credits

2 ABIM-MOC Points

2 Participation Credits

Overview
Faculty
Accreditation
Recommended

Learning Objectives
After completing this activity, learners should be able to:

Determine whether perioperative interruption of anticoagulation is necessary.
Chart the appropriate timing for preoperative cessation and postoperative resumption of anticoagulants.
Understand the indications for bridging anticoagulation in three clinical situations.
a. Patients with atrial fibrillation
b. Patients with mechanical heart valves
c. Patients with a history of venous thromboembolism.

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Faculty

Lily Ackermann, ScM, MD, FACS, SFHM
Annabel Frank
Barbara Slawski, MD, MS, SFHM
Margaret Fang, MD, MPH
Kurt Pfeifer, MD, FACP, SFHM, DFPM
Leonard Feldman, MD, FACP, FAAP, MHM

Faculty Disclosures
The individuals in control of content for this activity have no relevant relationships with ACCME-defined ineligible companies to disclose unless listed here. Any relevant relationships were mitigated prior to the start of this activity.

Accreditation Statement
The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Credit Statement
The Society of Hospital Medicine designates this enduring material for a maximum of 2.00 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

MOC Credit Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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