Dados do Trabalho

Título

Bleeding events in patients using clopidogrel undergoing thoracocentesis: a systematic review and meta-analysis.

Objetivo

Thoracocentesis is a commonly performed intervention in the intensive care unit and whether to discontinue clopidogrel prior to this procedure still is a debate in the medical community due to possible bleeding related complications. This meta-analysis aims to determine the proportion of bleeding events in patients using clopidogrel that undergo thoracocentesis and small-bore chest tube placement.

Métodos

We systematically searched PubMed, Embase and Cochrane Library for studies that evaluated the occurrence of bleeding events in patients undergoing thoracocentesis and small-bore chest tube placement. Included studies had complete data on the type of bleeding event and procedure performed and the information extraction was performed according to Cochrane recommendations. Proportion of events with 95% confidence intervals (CI) was calculated using a random-effects model considering the expected heterogeneity and Egger’s test for funnel plot asymmetry was used to determine publication bias.

Resultados

We retrieved a total of 392 observations from twelve included studies. The overall proportion of bleeding events was 0.0004 (95% CI: 0.0000-0.0102; I² = 0%). In the thoracocentesis subgroup analysis, the proportion of events was 0.0012 (95% CI: 0.0000-0.0148; I² = 0%). The Egger’s test for funnel plot asymmetry showed absence of substantial bias in the study selection (t = -0.0169, df = 10, p = 0.9868).

Conclusão

This study found a low occurrence of bleeding events in patients undergoing thoracocentesis and small-bore chest tube placement while using clopidogrel. These procedures can, therefore, be safely performed in those patients.