The postoperative venous thromboembolism (TREVO) study - risk and case mortality by surgical specialty (original) (raw)
Related papers
Pakistan Journal of Medical Sciences, 2018
Objective: To investigate the prevalence of and risk factors for Venous Thromboembolism (VTE) in postoperative patients. Methods: This descriptive, cross-sectional, retrospective study was conducted from August 2016 to October 2016 at two university hospitals and one public hospital. Total 217,354 patients records who underwent surgery in between 2010 and 2015 were examined. The study sample consisted of 123 patients who had postoperative venous thrombosis and pulmonary embolism, and whose discharge details, consultation data, diagnostic reports, and tests were examined in detail. Results: The prevalence of VTE in postoperative patients was 5.6/10,000. The mean age of the patients was 60.22±18.56 years. Of 123 patients, 51.20% were male, 30.90% were smokers, 46.30% had a comorbid disease, and 27.60% were diagnosed with cancer. Of the patients who had postoperative VTE, 65.0% had major surgery. Pharmacologic thromboprophylaxis was used in only 24.4% of patients (n=30). Conclusion: The prevalence of VTE in the present study is lower than that in other studies. Because surgery is a risk factor for VTE, patients who will be operated should be assessed. Considering the present results, we can assume that patients' conditions are not being assessed appropriately. In addition, findings indicate that a standard for preventing VTE has not yet been established.
Blood Advances
Background:Venous thromboembolism (VTE) is a common source of perioperative morbidity and mortality.Objective:These evidence-based guidelines from the American Society of Hematology (ASH) intend to support decision making about preventing VTE in patients undergoing surgery.Methods:ASH formed a multidisciplinary guideline panel balanced to minimize bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline-development process, including performing systematic reviews. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment.Results:The panel agreed on 30 recommendations, including for major surgery in general (n = 8), orthopedic surgery (n = 7), major general surgery (n = 3), major neurosurgical procedures (n = 2), urological surgery (n = 4), cardiac surgery and major vascular surgery (n = 2), major trauma (n = 2), and major gyneco...
Postoperatory Venous Thromboembolism: A Serious Preventable Risk
Revista Colombiana de Anestesiologia
La trombosis venosa profunda y el tromboembolismo pulmonar postoperatorio son complicaciones que tienen influencia en la morbimortalidad. Múltiples investigaciones evidencian sus cifras y la reducción del riesgo con la tromboprofilaxis. Han sido evaluados diferentes medicamentos y su nivel de protección, pero el seguimiento de las guías de práctica clínica publicadas no es óptimo debido a la falta de claridad en el manejo de pacientes con factores de riesgo intermedio. La prevención demostrada por la tromboprofilaxis obliga a implementar estrategias para detectar pacientes en riesgo y seguir las guías.
Thrombosis and Haemostasis, 2008
SummaryThere is little literature about the clinical presentation and timecourse of postoperative venous thromboembolism (VTE) in different surgical procedures. RIETE is an ongoing, prospective registry of consecutive patients with objectively confirmed, symptomatic acuteVTE.In this analysis,we analysed the baseline characteristics, thromboprophylaxis and therapeutic patterns, timecourse, and three-month outcome of all patients with postoperative VTE. As of January 2006, there were 1,602 patients with postoperativeVTE in RIETE: 393 (25%) after major orthopaedic surgery (145 elective hip arthroplasty, 126 knee arthroplasty, 122 hip fracture); 207 (13%) after cancer surgery; 1,002 (63%) after other procedures. The percentage of patients presenting with clinically overt pulmonary embolism (PE) (48%, 48%, and 50% respectively), the average time elapsed from surgery toVTE (22 ± 16, 24 ± 16, and 21 ± 15 days, respectively), and the three- month incidence of fatal PE (1.3%, 1.4%, and 0.8%,...
Prevention of Venous Thromboembolism in General Surgery at Gabriel Touré University Hospital in Mali
Surgical Science, 2021
Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians' Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.
Annals of Surgery, 2012
Authorship This manuscript represents the aggregate efforts of ten authors. Peri-operative risk stratification for venous thromboembolism after outpatient surgery is a broad topic that has relevance to a wide range of clinicians, administrators, and policymakers. Our author list reflects a cross section of the clinical care team to whom our manuscript is targeted, and has representation from general surgery, plastic and reconstructive surgery, vascular surgery, anesthesiology, hospital administration, and our office of clinical affairs. Each of the ten authors has fulfilled the criteria for authorship established by Annals of Surgery. Their specific contributions are listed below. All authors have reviewed this manuscript and give their final approval for submission. Specific contributions of each author: • Pannucci: Conception and design, analysis and interpretation of data, drafting of manuscript, statistical analysis • Kheterpal: Conception and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, administrative, technical, or material support, supervision Conflicts of Interest For the remaining authors none were declared.
BMJ open, 2014
Despite the burden of venous thromboembolism (VTE) among surgical patients on health systems in Australia, data on VTE incidence and its variation within Australia are lacking. We aim to explore VTE and subsequent mortality rates, trends and variations across Australian acute public hospitals. A large retrospective cohort study using all elective surgical patients in 82 acute public hospitals during 2002-2009 in New South Wales, Australia. Patients underwent elective surgery within 2 days of admission, aged between 18 and 90 years, and who were not transferred to another acute care facility; 4 362 624 patients were included. VTE incidents were identified by secondary diagnostic codes. Poisson mixed models were used to derive adjusted incidence rates and rate ratios (IRR). 2/1000 patients developed postoperative VTE. VTE increased by 30% (IRR=1.30, CI 1.19 to 1.42) over the study period. Differences in the VTE rates, trends between hospital peer groups and between hospitals with the ...
Journal of pediatric urology, 2018
Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE. Demographic, clinical, and peri-operative characteristics were collected. Descriptive statistics were performed, and multiple logistic regression models were created to estimate associated risk of VTE. In a cohort of 267,299 surgical cases, the 30-day incidence of post-operative VTE was 12 per 10,000 cases (0.12%). VTE incidence followed a bi-modal distribution, highest in infants and adolescents (Figure). Malignancy, pre-operative illness,...