Venous thromboembolism incidence in head and neck surgery patients

Analysis of the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database

Alia Mowery, Tyler Light, Daniel Clayburgh

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)22-28
Number of pages7
JournalOral Oncology
Volume77
DOIs
StatePublished - Feb 1 2018

Fingerprint

Venous Thromboembolism
Veterans
Quality Improvement
Neck
Head
Databases
Incidence
Mortality
Laryngectomy
Free Tissue Flaps
Operative Time
Ambulatory Surgical Procedures
Serum Albumin
Weight Loss
Thyroid Gland
Multivariate Analysis

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

@article{1583fcbd5f0a43a1a41f786d76fc9b6c,
title = "Venous thromboembolism incidence in head and neck surgery patients: Analysis of the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database",
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.",
keywords = "Deep vein thrombosis, Head and neck cancer, Morbidity, Mortality, Pulmonary embolus, Venous thromboembolism",
author = "Alia Mowery and Tyler Light and Daniel Clayburgh",
year = "2018",
month = "2",
day = "1",
doi = "10.1016/j.oraloncology.2017.12.002",
language = "English (US)",
volume = "77",
pages = "22--28",
journal = "Oral Oncology",
issn = "1368-8375",
publisher = "Elsevier Limited",

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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

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U2 - 10.1016/j.oraloncology.2017.12.002

DO - 10.1016/j.oraloncology.2017.12.002

M3 - Article

VL - 77

SP - 22

EP - 28

JO - Oral Oncology

JF - Oral Oncology

SN - 1368-8375

ER -