IF THERE is one thing that can be said with certainty about the perioperative management of oral anticoagulation as reviewed by Dunn and Turpie1 in this issue of the ARCHIVES, it is the authors' statement that "It is not possible to draw firm conclusions on the relative efficacy and safety of different management strategies using the available literature owing to variations in patient populations, procedures, anticoagulation regimens, definitions of events, and durations of follow-up." However, this is a management dilemma that is too important to say there is no answer. We must look at the available evidence, regardless of its quality, along with the extensive clinical experience with a drug that has been in use for over 60 years and try to arrive at recommendations as Dunn and Turpie have attempted to do in their timely review of this topic.
Ansell JE. The Perioperative Management of Warfarin Therapy. Arch Intern Med. 2003;163(8):881–883. doi:10.1001/archinte.163.8.881
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