perioperative_anticoagulation_pause: Perioperative Anticoagulation Use for Surgery Evaluation...

In cliot: Clinical Indices and Outcomes Tools

Perioperative Anticoagulation Use for Surgery Evaluation (PAUSE)

Description

Provides standardized perioperative management recommendations for patients with Atrial Fibrillation (AF) who are taking a Direct Oral Anticoagulant (DOAC) and require an elective surgery or procedure. The logic follows the PAUSE study protocol to minimize bleeding risk while preventing thromboembolism without heparin bridging.

Usage

perioperative_anticoagulation_pause(drug_name, procedure_bleeding_risk, crcl_ml_min)

Arguments

drug_name	String. The DOAC being used. Options: "apixaban", "rivaroxaban", "edoxaban", "dabigatran".
procedure_bleeding_risk	String. The bleeding risk associated with the planned procedure. Options: "low", "high".
crcl_ml_min	Numeric. Creatinine Clearance in mL/min. Used specifically to adjust interruption windows for Dabigatran or check validity for Xa inhibitors.

Value

A list containing:

PreOp_Recommendation	Instruction on how many days prior to surgery to stop the medication.
Last_Dose_Timing	Specific guidance on when the final pre-operative dose should be taken.
PostOp_Resumption	Guidance on when to restart the medication based on bleeding risk.

References

Douketis JD, Spyropoulos AC, Duncan J, et al. Perioperative Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant. JAMA Intern Med. 2019;179(11):1469-1478. doi:10.1001/jamainternmed.2019.2431

Examples

# Example 1: Apixaban, Low Risk Procedure
perioperative_anticoagulation_pause("apixaban", "low", 60)

# Example 2: Dabigatran, High Risk Procedure, Renal Impairment (CrCl 40)
perioperative_anticoagulation_pause("dabigatran", "high", 40)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.