{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T21:17:30Z","timestamp":1773350250198,"version":"3.50.1"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Elderly patients frequently receive antiplatelet therapy, creating a clinical dilemma between bleeding risk and cardiovascular protection during surgery. We evaluated the association between preoperative antiplatelet therapy and postoperative bleeding and cardiovascular events using multicenter observational data. Materials and Methods: We conducted a retrospective cohort study using standardized OMOP-CDM databases from 10 tertiary hospitals. Patients aged \u226565 years undergoing surgery were classified by preoperative aspirin or clopidogrel exposure. Propensity score matching was performed within each site. Hazard ratios (HRs) were estimated using Cox regression and pooled using meta-analytic techniques. Results: A total of 1464 exposed patients and 7038 matched comparators were analyzed. Across sites, hazard ratios varied without a statistically significant pooled association. The pooled HR for postoperative events was 1.01 (95% CI 0.57\u20131.78, p = 0.967). Covariate balance improved substantially after matching. Conclusions: Preoperative antiplatelet therapy was not associated with a consistent increase in postoperative bleeding or cardiovascular events in elderly surgical patients. These findings support individualized perioperative management rather than routine discontinuation.<\/jats:p>","DOI":"10.3390\/medicina62030521","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:43:18Z","timestamp":1773240198000},"page":"521","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multicenter Propensity Score-Matched Cohort Study of Preoperative Antiplatelet Therapy and Postoperative Outcomes in Elderly Surgical Patients"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5653-7005","authenticated-orcid":false,"given":"Seokyoung","family":"Song","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4574-9122","authenticated-orcid":false,"given":"Hyungseok","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Il Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minsoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon 24289, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lim Youn","family":"Hee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5125-3129","authenticated-orcid":false,"given":"Jung Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul 02447, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soo Il","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, International St. Mary\u2019s Hospital, Incheon 22711, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Hyuck","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Hun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moonki","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang 10474, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-1095","authenticated-orcid":false,"given":"Jong Bum","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Ajou University Medical Center, Suwon 16477, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2483-2613","authenticated-orcid":false,"given":"Cheolhyeong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Iksan 54538, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-7198","authenticated-orcid":false,"given":"Seung Hee","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho Kyung","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan","family":"Noh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong Young","family":"Choi","sequence":"additional","affiliation":[{"name":"EvidNet, Gangnam-gu, Seoul 06164, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0398-5514","authenticated-orcid":false,"given":"Sang Gyu","family":"Kwak","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Medicine, Daegu Catholic University, Duryugongwon-Ro 17-Gil 33, Nam-Gu, Daegu 42472, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1093\/eurheartj\/ehu282","article-title":"2014 ESC\/ESA Guidelines on non-cardiac surgery: Cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: Cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA)","volume":"35","author":"Kristensen","year":"2014","journal-title":"Eur. 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Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/521\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T10:46:26Z","timestamp":1773312386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["medicina62030521"],"URL":"https:\/\/doi.org\/10.3390\/medicina62030521","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]}}}