Quality and Patient Safety Articles-Safety of Direct Oral Anticoagulants (DOACS) in Needle EMG

Safety of Direct Oral Anticoagulants (DOACS) in Needle EMG

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The safety of direct oral anticoagulants (DOACs) in needle electromyography (EMG) procedures has not been well studied. While EMG is generally considered safe with minimal risk of bleeding complications, there is inconsistency in practice patterns among physicians when it comes to patients on anticoagulants. A small retrospective study by Nagarajan examined the risk of hematoma after EMG in patients on DOACs and warfarin. The study involved 58 patients, evenly split between the DOAC and warfarin groups, who underwent neuromuscular ultrasound for hematoma detection. Of the nine cases of bleeding identified, seven were in the DOAC group and two were in the warfarin group. However, there were no major bleeding complications reported. The incidence of hemorrhagic complications was found to be 24.1% for DOACs compared to 7% for warfarin based on this small study. But more data from larger, prospective studies is needed to draw definitive conclusions. Caution should be exercised during needle EMG in patients on both DOACs and warfarin. Overall, the current evidence suggests that the risk of hemorrhagic complications during needle EMG in patients taking DOACs may be low, but further research is necessary to establish a more conclusive understanding of the safety profile.

Keywords

direct oral anticoagulants

DOACs

needle electromyography

EMG procedures

safety

bleeding complications

physicians

retrospective study

hematoma

warfarin