TY - JOUR
T1 - Timing and characteristics of venous thromboembolism after noncancer surgery
AU - Expósito-Ruiz, Manuela
AU - Arcelus, Juan Ignacio
AU - Caprini, Joseph A.
AU - López-Espada, Cristina
AU - Bura-Riviere, Alessandra
AU - Amado, Cristina
AU - Loring, Mónica
AU - Mastroiacovo, Daniela
AU - Monreal, Manuel
AU - RIETE Investigators
A2 - Prandoni, Paolo
A2 - Brenner, Benjamin
A2 - Farge-Bancel, Dominique
A2 - Barba, Raquel
A2 - Di Micco, Pierpaolo
A2 - Bertoletti, Laurent
A2 - Schellong, Sebastian
A2 - Tzoran, Inna
A2 - Reis, Abilio
A2 - Bosevski, Marijan
A2 - Bounameaux, Henri
A2 - Malý, Radovan
A2 - Verhamme, Peter
A2 - Bui, Hanh My
A2 - Adarraga, M. D.
A2 - Agud, M.
A2 - Aibar, J.
A2 - Aibar, M. A.
A2 - Amado, C.
A2 - Arcelus, J. I.
A2 - Baeza, C.
A2 - Ballaz, A.
A2 - Barba, R.
A2 - Barbagelata, C.
A2 - Barrón, M.
A2 - Barrón-Andrés, B.
A2 - Blanco-Molina, A.
A2 - Botella, E.
A2 - Camon, A. M.
A2 - Campos, S.
A2 - Cañas, I.
A2 - Casado, I.
A2 - Castro, J.
A2 - Criado, J.
A2 - de Ancos, C.
A2 - de Miguel, J.
A2 - Toro, J. del
A2 - Demelo-Rodríguez, P.
A2 - Díaz-Pedroche, C.
A2 - Ģībietis, Valdis
A2 - Kigitovica, D.
A2 - Skride, A.
N1 - Funding Information:
We express our gratitude to Sanofi Spain for supporting the RIETE registry with an unrestricted educational grant. We also thank the RIETE Registry Coordinating Center, S&H Medical Science Service, for their quality control data and logistical and administrative support. The results reported in this article form part of the doctoral thesis of Manuela Exp?sito Ruiz, enrolled in the Clinical Medicine and Public Health doctorate programme at the University of Granada, Granada, Spain. The editors and reviewers of this article have no relevant financial relationships to disclose per the Journal policy that requires reviewers to decline review of any manuscript for which they may have a conflict of interest.
Publisher Copyright:
© 2020 Society for Vascular Surgery
PY - 2021/7
Y1 - 2021/7
N2 - Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods: We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results: The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions: The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week.
AB - Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods: We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results: The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions: The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week.
KW - Deep vein thrombosis
KW - Duration of risk
KW - Pulmonary embolism
KW - Surgery
KW - Thromboprophylaxis
UR - http://www.scopus.com/inward/record.url?scp=85106334294&partnerID=8YFLogxK
UR - https://www.sciencedirect.com/science/article/abs/pii/S2213333X20306442
UR - https://www.riete.org/info/centros_participantes/index.php
U2 - 10.1016/j.jvsv.2020.11.017
DO - 10.1016/j.jvsv.2020.11.017
M3 - Article
C2 - 33248295
AN - SCOPUS:85106334294
SN - 2213-333X
VL - 9
SP - 859-867.e2
JO - Journal of Vascular Surgery: Venous and Lymphatic Disorders
JF - Journal of Vascular Surgery: Venous and Lymphatic Disorders
IS - 4
ER -