gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Low-dose aspirin before intracranial and spinal surgery – Results of a survey among neurosurgeons in Germany

Niedrigdosiertes Aspirin vor intrakraniellen und spinalen Operationen – Ergebnisse einer Umfrage unter deutschen Neurochirurgen

Meeting Abstract

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  • corresponding author M. C. Korinth - Neurochirurgische Klinik, Universitätsklinikum RWTH Aachen
  • M. F. Oertel - Neurochirurgische Klinik, Universitätsklinikum RWTH Aachen
  • J. M. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.03.01

The electronic version of this article is the complete one and can be found online at:

Published: April 11, 2007
Published with erratum: June 3, 2009

© 2007 Korinth et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Increasing numbers of patients presenting for intracranial and spinal surgery are receiving concurrent medication with low-dose aspirin, leading to dysfunctional circulating platelets. The contribution of low-dose aspirin to increased peri-operative risk of bleeding and blood loss is a contentious issue with conflicting published results from different surgical groups. Data from neurosurgical patients is sparse. We surveyed the opinions and working practices of neurosurgical facilities in Germany regarding patients who present with aspirin medication before elective spinal and intracranial surgery.

Methods: Identical questionnaires were sent to 210 neurosurgical facilities asking five main questions: (1) the adherence of any policy of stopping aspirin pre-operatively, (2) the personal risk assessment for patients with surgery under low-dose aspirin medication, (3) the preferred method of treatment for excessive bleeding in this context, (4) personal knowledge of hemorrhagic complications in this group of patients, and (5) characteristics of the neurosurgical units concerned.

Results: There were 142 (67.6%) valid responses. Of the respondents, 80.4% had a departmental policy for the discontinuation of pre-operative aspirin treatment. The mean time suggested for discontinuation of aspirin was 7.3 days before intracranial (A) and 6.9 days before spinal (B) surgery (range: 0-21 days). 106 respondents (76.8%/A) – 94 respondents (66.2%/B) considered that patients taking low-dose aspirin were at increased risk for excessive peri-operative hemorrhage, and 80 (57.2%/A) – 73 (51.4%/B) reported having personal experience of such problems. 97 respondents (70.3%/A) – 92 (64.8%/B) used special medical therapy, preferably desmopressin alone or in combination with other blood products or prohemostatic agents, if hemorrhagic complications developed intra-operatively. The average number of operations per year in each service was 494 (A) range: 50-1700) and 608 (B) (range: 40-1500).

Conclusions: The majority of neurosurgical facilities in Germany have distinct departmental policies concerning the discontinuation of low-dose aspirin pre-operatively, with an average of 7.1 days. Two-thirds to three-quarters of the respondents felt that aspirin was a risk factor for hemorrhagic complications associated with neurosurgical procedures, and more than half of the interviewees reported having personal experience of such problems.


Primarily the author M. F. Oertel had been omitted.