Abstract
Objective Venous thromboembolism (VTE) may cause significant postoperative morbidity and mortality; research in other surgical fields suggests an elevated VTE risk persists up to 30 days after surgery, beyond hospital discharge. We performed a review of the Veteran's Affairs Surgical Quality Improvement Project (VASQIP) database to determine the 30-day incidence of VTE following head and neck surgery and assess the proportion of VTE that occur post-discharge. Materials and methods A retrospective review was performed of all head and neck ablative procedures captured in the VASQIP database between 1991 and 2015. Post-operative VTE incidence was determined and the relationship of pre-operative data and post-operative mortality to VTE incidence was assessed. Results 48,986 patients were included in the study; there were 152 VTE events (0.31%) and 39 (25.7%) occurred post-discharge. Lower VTE rates were found in parotidectomies (0.22%) and thyroid/parathyroid cases (0.23%), and higher rates in free flap (1.52%) and laryngectomy cases (0.69%). Age >70, recent weight loss, low serum albumin, and increased surgical time were all associated with increased VTE incidence on multivariate analysis. 90-day mortality in patients without VTE was 2.1% compared to 19.7% in patients who experienced a VTE. Conclusion While the documented rate of VTE in a national dataset is relatively low following head and neck surgeries, it is elevated with certain procedure categories and following long operations, and a significant proportion of VTE occur post-discharge. This study provides baseline data to better inform efforts to risk-stratify and customize thromboprophylaxis for patients undergoing head and neck procedures.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 22-28 |
| Number of pages | 7 |
| Journal | Oral Oncology |
| Volume | 77 |
| DOIs | |
| State | Published - Feb 1 2018 |
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Keywords
- Deep vein thrombosis
- Head and neck cancer
- Morbidity
- Mortality
- Pulmonary embolus
- Venous thromboembolism
ASJC Scopus subject areas
- Oral Surgery
- Oncology
- Cancer Research
Cite this
Venous thromboembolism incidence in head and neck surgery patients : Analysis of the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. / Mowery, Alia; Light, Tyler; Clayburgh, Daniel.
In: Oral Oncology, Vol. 77, 01.02.2018, p. 22-28.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Venous thromboembolism incidence in head and neck surgery patients
T2 - Analysis of the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database
AU - Mowery, Alia
AU - Light, Tyler
AU - Clayburgh, Daniel
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Objective Venous thromboembolism (VTE) may cause significant postoperative morbidity and mortality; research in other surgical fields suggests an elevated VTE risk persists up to 30 days after surgery, beyond hospital discharge. We performed a review of the Veteran's Affairs Surgical Quality Improvement Project (VASQIP) database to determine the 30-day incidence of VTE following head and neck surgery and assess the proportion of VTE that occur post-discharge. Materials and methods A retrospective review was performed of all head and neck ablative procedures captured in the VASQIP database between 1991 and 2015. Post-operative VTE incidence was determined and the relationship of pre-operative data and post-operative mortality to VTE incidence was assessed. Results 48,986 patients were included in the study; there were 152 VTE events (0.31%) and 39 (25.7%) occurred post-discharge. Lower VTE rates were found in parotidectomies (0.22%) and thyroid/parathyroid cases (0.23%), and higher rates in free flap (1.52%) and laryngectomy cases (0.69%). Age >70, recent weight loss, low serum albumin, and increased surgical time were all associated with increased VTE incidence on multivariate analysis. 90-day mortality in patients without VTE was 2.1% compared to 19.7% in patients who experienced a VTE. Conclusion While the documented rate of VTE in a national dataset is relatively low following head and neck surgeries, it is elevated with certain procedure categories and following long operations, and a significant proportion of VTE occur post-discharge. This study provides baseline data to better inform efforts to risk-stratify and customize thromboprophylaxis for patients undergoing head and neck procedures.
AB - Objective Venous thromboembolism (VTE) may cause significant postoperative morbidity and mortality; research in other surgical fields suggests an elevated VTE risk persists up to 30 days after surgery, beyond hospital discharge. We performed a review of the Veteran's Affairs Surgical Quality Improvement Project (VASQIP) database to determine the 30-day incidence of VTE following head and neck surgery and assess the proportion of VTE that occur post-discharge. Materials and methods A retrospective review was performed of all head and neck ablative procedures captured in the VASQIP database between 1991 and 2015. Post-operative VTE incidence was determined and the relationship of pre-operative data and post-operative mortality to VTE incidence was assessed. Results 48,986 patients were included in the study; there were 152 VTE events (0.31%) and 39 (25.7%) occurred post-discharge. Lower VTE rates were found in parotidectomies (0.22%) and thyroid/parathyroid cases (0.23%), and higher rates in free flap (1.52%) and laryngectomy cases (0.69%). Age >70, recent weight loss, low serum albumin, and increased surgical time were all associated with increased VTE incidence on multivariate analysis. 90-day mortality in patients without VTE was 2.1% compared to 19.7% in patients who experienced a VTE. Conclusion While the documented rate of VTE in a national dataset is relatively low following head and neck surgeries, it is elevated with certain procedure categories and following long operations, and a significant proportion of VTE occur post-discharge. This study provides baseline data to better inform efforts to risk-stratify and customize thromboprophylaxis for patients undergoing head and neck procedures.
KW - Deep vein thrombosis
KW - Head and neck cancer
KW - Morbidity
KW - Mortality
KW - Pulmonary embolus
KW - Venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85038017951&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85038017951&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2017.12.002
DO - 10.1016/j.oraloncology.2017.12.002
M3 - Article
AN - SCOPUS:85038017951
VL - 77
SP - 22
EP - 28
JO - Oral Oncology
JF - Oral Oncology
SN - 1368-8375
ER -