Two novel risk factors for postoperative venous thromboembolism: A reconsideration of standard risk assessment and prophylaxis
| Autor: | Stephanie C. Vaughn, Frederick Thurston Drake, Stephanie D. Talutis, Pamela Rosenkranz, Michael R. Cassidy, Sowmya R. Rao, Teviah E. Sachs, David McAneny |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Databases Factual 030204 cardiovascular system & hematology Risk Assessment Sepsis Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Standard Risk Internal medicine Statistical analyses medicine Humans cardiovascular diseases Aged Retrospective Studies Aged 80 and over Postoperative Care business.industry Anticoagulants Venous Thromboembolism General Medicine Perioperative Odds ratio Middle Aged medicine.disease Logistic Models 030220 oncology & carcinogenesis Chemoprophylaxis Female Surgery Risk assessment business Venous thromboembolism |
| Zdroj: | The American Journal of Surgery. 220:1338-1343 |
| ISSN: | 0002-9610 |
| Popis: | Background Postoperative venous thromboembolism (VTE) is usually preventable with adequate prophylaxis. In an institutional study, patients with emergency operations (EO), multiple operations (MO), and perioperative sepsis (PS) were more likely to develop VTE despite standard prophylaxis. Methods General surgery patients in the NSQIP database from 2011 to 2014 were stratified into VTE and non-VTE groups, and statistical analyses were performed. Results Among 1,610,086 patients, 13,673 (0.8%) were diagnosed with VTE. The VTE odds ratios for patients with EO, MO and PS were 1.4 (95%CI:1.3–1.5), 1.9 (95%CI:1.7–2.0), and 2.4 (95%CI:2.2–2.5), respectively. VTE odds ratios increased with concurrence of two factors (EO+PS: 2.0 (95%CI:1.9–2.2)) (EO+MO: 2.3 (95%CI:1.9–2.7)) (MO+PS: 2.5 (95%CI:2.2–2.7)) and further still for patients with all three factors (2.7, 95%CI:2.4–3.0). Conclusion General surgery patients with EO, MO, or PS have a greater likelihood of developing postoperative VTE. These factors are not necessarily captured in contemporary risk assessment models that guide chemoprophylaxis, and so these high-risk patients may receive insufficient prophylaxis. |
| Databáze: | OpenAIRE |
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