Top

World Journal of Surgery

Published in:

01-06-2016 | Original Scientific Report

Preoperative Pneumonia and Postoperative Venous Thrombosis: A Cohort Study of 427,656 Patients Undergoing Major General Surgery

Authors: Karim Z. Masrouha, Khaled M. Musallam, Frits R. Rosendaal, Jamal J. Hoballah, Faek R. Jamali

Published in: World Journal of Surgery | Issue 6/2016

Abstract

Background

The literature is sparse regarding the association between pneumonia and venous thrombosis in surgical patients. The aim of this study was to investigate the risk of postoperative venous thrombosis in patients who fit the criteria for preoperative pneumonia using data from the ongoing American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database while adjusting for potential confounders.

Methods

This is a cohort study using data from the ACS NSQIP database participating sites from 2008 (211 sites) and 2009 (237 sites). 427,656 patients undergoing major general surgery were included. The 30-day risk of postoperative venous thrombosis including deep vein thrombosis (DVT) and pulmonary embolism (PE) was evaluated in patients with preoperative pneumonia diagnosed before undergoing major general surgery.

Results

Patients with preoperative pneumonia had a higher incidence of both 30-day DVT and PE than patients without preoperative pneumonia. After adjusting for all potential confounders, the effect estimates for the association between preoperative pneumonia and venous thrombosis were DVT, OR: 1.67 (95% CI 1.32–2.11) and PE, OR: 2.18 (95% CI 1.48–3.22).

Conclusions

A large, multicenter database of surgical patients showed that preoperative pneumonia may increase risk for developing venous thrombosis. This adds to our understanding of risk factors for venous thrombosis and suggests a potential benefit of diagnosing preoperative pneumonia in patients undergoing major general surgery.

Available only for authorised users

Shorr AF, Sarnes MW, Peeples PJ et al (2007) Comparison of cost, effectiveness, and safety of injectable anticoagulants used for thromboprophylaxis after orthopedic surgery. Am J Health Syst Pharm 64:2349–2355CrossRefPubMed

Geerts WH, Pineo GF, Heit JA et al (2004) Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:338S–400SCrossRefPubMed

Quist-Paulsen P, Naess IA, Cannegieter SC et al (2010) Arterial cardiovascular risk factors and venous thrombosis: results from a population-based, prospective study (the HUNT 2). Haematologica 95:119–125CrossRefPubMedPubMedCentral

Fox EA, Kahn SR (2005) The relationship between inflammation and venous thrombosis. A systematic review of clinical studies. Thromb Haemost 94:362–365PubMed

Tichelaar YI, Kluin-Nelemans HJ, Meijer K (2012) Infections and inflammatory diseases as risk factors for venous thrombosis. A systematic review. Thromb Haemost 107:827–837CrossRefPubMed

Gangireddy C, Rectenwald JR, Upchurch GR et al (2007) Risk factors and clinical impact of postoperative symptomatic venous thromboembolism. J Vasc Surg 45:335–341 discussion 341–332 CrossRefPubMed

Musallam KM, Tamim HM, Richards T et al (2011) Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 378:1396–1407CrossRefPubMed

Khuri SF, Henderson WG, Daley J et al (2007) The patient safety in surgery study: background, study design, and patient populations. J Am Coll Surg 204:1089–1102CrossRefPubMed

Fink AS, Campbell DA Jr, Mentzer RM Jr et al (2002) The National Surgical Quality Improvement Program in non-veterans administration hospitals: initial demonstration of feasibility. Ann Surg 236:344–353 discussion 353–344 CrossRefPubMedPubMedCentral

10.

Yang C, Huang N, Shi B (2011) Clinical research of presurgical orthodontic treatment of complete cleft lip and palate infant. Hua Xi Kou Qiang Yi Xue Za Zhi 29:396–399PubMed

11.

Agnelli G, Bolis G, Capussotti L et al (2006) A clinical outcome-based prospective study on venous thromboembolism after cancer surgery: the @RISTOS project. Ann Surg 243:89–95CrossRefPubMedPubMedCentral

12.

Clayton TC, Gaskin M, Meade TW (2011) Recent respiratory infection and risk of venous thromboembolism: case–control study through a general practice database. Int J Epidemiol 40:819–827CrossRefPubMedPubMedCentral

13.

Schmidt M, Horvath-Puho E, Thomsen RW et al (2012) Acute infections and venous thromboembolism. J Intern Med 271:608–618CrossRefPubMedPubMedCentral

14.

Ribeiro DD, Lijfering WM, Van Hylckama Vlieg A et al (2012) Pneumonia and risk of venous thrombosis: results from the MEGA study. J Thromb Haemost 10:1179–1182CrossRefPubMed

15.

Gross ME, Vogler SA, Mone MC et al (2014) The importance of extended postoperative venous thromboembolism prophylaxis in IBD: a National Surgical Quality Improvement Program analysis. Dis Colon Rectum 57:482–489CrossRefPubMed

16.

Smeeth L, Cook C, Thomas S et al (2006) Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting. Lancet 367:1075–1079CrossRefPubMed

17.

Monn MF, Hui X, Lau BD et al (2014) Infection and venous thromboembolism in patients undergoing colorectal surgery: what is the relationship? Dis Colon Rectum 57(4):497–505CrossRefPubMedPubMedCentral

Title: Preoperative Pneumonia and Postoperative Venous Thrombosis: A Cohort Study of 427,656 Patients Undergoing Major General Surgery
Authors: Karim Z. Masrouha
Khaled M. Musallam
Frits R. Rosendaal
Jamal J. Hoballah
Faek R. Jamali
Publication date: 01-06-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 6/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3409-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preoperative Pneumonia and Postoperative Venous Thrombosis: A Cohort Study of 427,656 Patients Undergoing Major General Surgery

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2016

Improving Safety in Laparoscopic Cholecystectomy: Reply

Variation on a Theme: Alternative to Plastic Bag in ALPPS Procedures—Feasibility and Clinical Safety of COVA+™ Membrane in ALPPS Procedure

The Predictive Value of Indocyanine Green Clearance in Future Liver Remnant for Posthepatectomy Liver Failure Following Hepatectomy with Extrahepatic Bile Duct Resection

Cholecystectomy Causes Ultrasound Evidence of Increased Hepatic Steatosis

Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

Body Mass Index and Stump Morphology Predict an Increased Incidence of Pancreatic Fistula After Pancreaticoduodenectomy