PB1182 - Post-Operative Bleeding and Thrombosis in Biological Females with Inherited Bleeding Disorders: A Cross-Sectional Analysis from the Community Counts Registry

Background: Providers are in dire need of information to guide hemostatic therapy planning in the peri-procedural interval for biological females with inherited bleeding disorders (IBD). This is most evident in the treatment of older patients in whom the risk of bleeding is thought to be entangled with age-associated venous and arterial vascular disease risks.

Aims: This study aims to report the frequency of post-operative bleeding and thrombotic events in older biological females with IBDs.

Methods: With institutional IRB approval, we performed a cross-sectional analysis of the Center for Disease Controls’ Community Counts registry which records clinical information from individuals with IBD during each clinical visit. Information was requested for all biological females older than 44 years of age seen between the years 2000 and 2022. Results are provided as descriptive statistics and odds ratios.

Results: Out of 2,032 clinical visits, 578 surgeries were reported (Table 1) and 216 (37.3%) of these were associated with adverse bleeding.

Twenty-nine subjects (5%) experienced 34 arterial or venous thrombotic events in association with a surgical procedure (Table 2). Individuals with a venous or arterial thrombotic event were 30% less likely to have received hemostatic therapy in association with their procedure (OR = 0.7).

Conclusion(s): This is the first study to report the frequency of bleeding and thrombotic events associated with surgical intervention in older biological females with IBDs. These results do not support the hypothesis that hemostatic therapies increase the risk of post-operative thrombotic complications in this population; though, the limitations of our methodological approach restricted our ability to properly assess this association. Despite an age-associated increased risk of venous and arterial thrombosis, older biological females with IBDs remain at risk for surgical-associated bleeding and additional investigation is needed to incorporate this information into individualized risk stratification assessments to guide the use of hemostatic therapies.