{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:24:03Z","timestamp":1760145843744,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\u2014Anticoagulants, such as vitamin-K antagonists (VKA) and direct oral anticoagulants (DOAC), are widely used among patients who undergo endoscopic procedures. To balance between bleeding and thromboembolic risks, careful decisions must be made about whether and for how long anticoagulants have to be stopped peri-endoscopically and if bridging is necessary. We created a tool in the electronic health records system (EHR) HIX (Microsoft) for invasive procedures to aid this decision-making. By selecting the anticoagulant indication or thrombo-embolic risk and the bleeding risk of the procedure, the tool automatically generates advice for periprocedural anticoagulant management. Objectives\u2014This study assesses whether the tool is used properly peri-endoscopically. Secondly, it examines how many bleeding and thromboembolic events have occurred since the implementation of the tool. Methods\u2014This retrospective study included all orders placed for endoscopies for patients using VKA or DOAC between 2018 and 2021. Results\u2014In total, 986 endoscopies were included for analysis. In 89%, the tool was used correctly; the main error was selecting the wrong bleeding risk (7.5%). The cumulative incidence for moderate or severe bleeding events for DOAC and VKA was 2 (0.5%) and 0, respectively. The cumulative incidence of thromboembolic events for DOAC and VKA was 1 (0.2%) for each. Conclusions\u2014This study evaluates the use of an EHR-integrated decision-making tool to aid peri-endoscopic anticoagulant management. By analysing the usage of the tool, we formulated several suggestions to improve the tool. Although this study is not a comparative one, we can conclude that the thromboembolic and major bleeding risks were low.<\/jats:p>","DOI":"10.3390\/jcm13175194","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T10:07:35Z","timestamp":1725271655000},"page":"5194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Tool Integrated into the Electronic Health Record to Guide Proper Decision-Making Regarding Peri-Endoscopic Anticoagulant Management: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Anja","family":"Plender","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne E.","family":"Graumans","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Gielisse","sequence":"additional","affiliation":[{"name":"Department of Gastro-Enterology, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlinda","family":"Bresser-de Ruyter","sequence":"additional","affiliation":[{"name":"Department of Research Internal Medicine, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Sissing","sequence":"additional","affiliation":[{"name":"Department of Research Internal Medicine, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjan C.","family":"Ruiter-Jakobs","sequence":"additional","affiliation":[{"name":"Department of Quality & Patient Safety, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arian","family":"Wals","sequence":"additional","affiliation":[{"name":"Department of ICT Application Management, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura M.","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Hematology, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,1]]},"reference":[{"key":"ref_1","unstructured":"SFK (2020). 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