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Published in: Perioperative Medicine 1/2019

Open Access 01-12-2019 | Research

A significant proportion of venous thromboembolism events in general surgical patients occurs after discharge: analysis of the ACS-NSQIP Essentials database

Authors: Abdelghaffar K. Salous, Ashraf Reyad, Karen Sweeney, Arun Mavanur

Published in: Perioperative Medicine | Issue 1/2019

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Abstract

Background

Venous thromboembolism (VTE) is a major cause of morbidity and mortality in general surgical patients.

Methods

The ACS-NSQIP database was queried and VTE data were collected and analyzed to assess the incidence of VTE at a 500-bed, non-profit, teaching, inner city, community hospital and similar peer institutions from January 1, 2006 to December 31, 2011.

Results

Post-discharge VTE events accounted for 40% of all VTE events within 30 days of discharge. Data show a significant proportion of post-discharge VTE events that may be preventable with extending VTE prophylaxis in the post-discharge period.

Conclusion

This is the first paper to report on this high post-discharge incidence of VTE in general surgical patients and to recommend continuation of VTE prophylaxis in the post-discharge period.
Literature
go back to reference Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A, Dietrich-Neto F, Investigators EI. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med. 2002;346:975–80.CrossRef Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A, Dietrich-Neto F, Investigators EI. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med. 2002;346:975–80.CrossRef
go back to reference Cohoon KP, Leibson CL, Ransom JE, Ashrani AA, Petterson TM, Long KH, Bailey KR, Heit JA. Costs of venous thromboembolism associated with hospitalization for medical illness. Am J Manag Care. 2015;21:e255–63.PubMedPubMedCentral Cohoon KP, Leibson CL, Ransom JE, Ashrani AA, Petterson TM, Long KH, Bailey KR, Heit JA. Costs of venous thromboembolism associated with hospitalization for medical illness. Am J Manag Care. 2015;21:e255–63.PubMedPubMedCentral
go back to reference Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, Ortel TL, Pauker SG, Colwell CW Jr. American College of Chest P: Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e278S–325S.CrossRef Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, Ortel TL, Pauker SG, Colwell CW Jr. American College of Chest P: Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e278S–325S.CrossRef
go back to reference Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:338S–400S.CrossRef Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:338S–400S.CrossRef
go back to reference Heit JA. Epidemiology of venous thromboembolism. Nat Rev Cardiol. 2015;12:464–74.CrossRef Heit JA. Epidemiology of venous thromboembolism. Nat Rev Cardiol. 2015;12:464–74.CrossRef
go back to reference Heit JA, Mohr DN, Silverstein MD, Petterson TM, O'Fallon WM, Melton LJ 3rd. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Intern Med. 2000;160:761–8.CrossRef Heit JA, Mohr DN, Silverstein MD, Petterson TM, O'Fallon WM, Melton LJ 3rd. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Intern Med. 2000;160:761–8.CrossRef
go back to reference Heit JA, O'Fallon WM, Petterson TM, Lohse CM, Silverstein MD, Mohr DN, Melton LJ 3rd. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med. 2002;162:1245–8.CrossRef Heit JA, O'Fallon WM, Petterson TM, Lohse CM, Silverstein MD, Mohr DN, Melton LJ 3rd. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med. 2002;162:1245–8.CrossRef
go back to reference Huang W, Goldberg RJ, Anderson FA, Kiefe CI, Spencer FA. Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009). Am J Med. 2014;127:829–39 e825.CrossRef Huang W, Goldberg RJ, Anderson FA, Kiefe CI, Spencer FA. Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009). Am J Med. 2014;127:829–39 e825.CrossRef
go back to reference Rasmussen MS, Jorgensen LN, Wille-Jorgensen P, Nielsen JD, Horn A, Mohn AC, Somod L, Olsen B, Investigators F. Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: a multicenter randomized open-label study. J Thromb Haemost. 2006;4:2384–90.CrossRef Rasmussen MS, Jorgensen LN, Wille-Jorgensen P, Nielsen JD, Horn A, Mohn AC, Somod L, Olsen B, Investigators F. Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: a multicenter randomized open-label study. J Thromb Haemost. 2006;4:2384–90.CrossRef
go back to reference Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ 3rd. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158:585–93.CrossRef Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ 3rd. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158:585–93.CrossRef
go back to reference Thaler J, Pabinger I, Ay C. Anticoagulant Treatment of Deep Vein Thrombosis and Pulmonary Embolism: The Present State of the Art. Front Cardiovasc Med. 2015;2:30.CrossRef Thaler J, Pabinger I, Ay C. Anticoagulant Treatment of Deep Vein Thrombosis and Pulmonary Embolism: The Present State of the Art. Front Cardiovasc Med. 2015;2:30.CrossRef
Metadata
Title
A significant proportion of venous thromboembolism events in general surgical patients occurs after discharge: analysis of the ACS-NSQIP Essentials database
Authors
Abdelghaffar K. Salous
Ashraf Reyad
Karen Sweeney
Arun Mavanur
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Perioperative Medicine / Issue 1/2019
Electronic ISSN: 2047-0525
DOI
https://doi.org/10.1186/s13741-019-0131-1

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