{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T04:08:08Z","timestamp":1742270888987,"version":"3.40.1"},"reference-count":0,"publisher":"Journal of Nepal Medical Association (JNMA)","issue":"283","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Nepal Med Assoc"],"abstract":"<jats:p>Perioperative care requires a comprehensive assessment of the risks of bleeding and thrombosis. The 2022 CHEST Guidelines offer an empirical foundation for customized treatment using clinical judgment and risk assessment based on CHA2DS2-VASC and HAS-BLED scores. Despite the ease of access to anticoagulation guidelines, decision-making remains challenging, particularly when determining the necessity of bridging therapy with unfractionated or low-molecular-weight heparin. To facilitate this decision, we provide a mnemonic, STREAM, that highlights high-risk situations that require bridging. These include recent stroke or transient ischemic attack, severe thrombophilia, rheumatic valvular disease, recent venous thromboembolism, atrial fibrillation with high CHA2DS2-VASC scores, and mechanical heart valves. This mnemonic offers physicians a methodical approach to optimize perioperative anticoagulation control while minimizing the risk of hemorrhage and thrombosis.<\/jats:p>","DOI":"10.31729\/jnma.8910","type":"journal-article","created":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T09:32:57Z","timestamp":1740821577000},"page":"199-201","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Anticoagulation and Risk Assessment: Building a Bridge Over a STREAM"],"prefix":"10.31729","volume":"63","author":[{"given":"Anil","family":"Harrison","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushil","family":"Rayamajhi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16919","published-online":{"date-parts":[[2025,2,28]]},"container-title":["Journal of Nepal Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/jnma.com.np\/jnma\/index.php\/jnma\/article\/download\/8910\/5207","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jnma.com.np\/jnma\/index.php\/jnma\/article\/download\/8910\/5207","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T09:41:48Z","timestamp":1742204508000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnma.com.np\/jnma\/index.php\/jnma\/article\/view\/8910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":0,"journal-issue":{"issue":"283","published-online":{"date-parts":[[2025,3,1]]}},"URL":"https:\/\/doi.org\/10.31729\/jnma.8910","relation":{},"ISSN":["1815-672X","0028-2715"],"issn-type":[{"type":"electronic","value":"1815-672X"},{"type":"print","value":"0028-2715"}],"subject":[],"published":{"date-parts":[[2025,2,28]]}}}