Abstract 20013: Perioperative Venous Thromboembolism occurs outside the operating room
Introduction: Venous thromboembolism (VTE) is a recognized complication of surgery. However, it is unknown what the prevalence of preoperative subclinical VTE in the general population of surgical patients and how much this may contribute to clinically symptomatic VTE postoperatively.
Hypothesis: We hypothesized that subclinical (asymptomatic) lower extremity (LE) VTE was associated with the development of clinically symptomatic VTE post-operatively. The main objective was to characterize the preoperative prevalence of LE VTEs and understand the time-frame and risk factors that contribute to symptomatic VTE development after surgery.
Methods: 230 patients (>18 years) scheduled for any surgical procedure at a tertiary referral hospital between February 2011 and May 2012 were enrolled in an IRB approved prospective observational study. Bilateral LE duplex ultrasound examinations (groin to ankle) were performed immediately prior to surgery and within 24 hours post-operative. Data were prospectively collected and analyzed out to 6 months to identify the development of VTE.
Results: Subclinical VTEs were not detected preoperatively or 24 hours post-operative in any patient. 9/230 (3.9%) developed symptomatic VTE in the 30 day follow-up period and 12/230 (5.2%) within 6 months. VTE development correlated with ASA status (P = 0.048) and orthopedic procedures (P = 0.003). Five of the 42 orthopedic patients (11.9%) developed a VTE in 30 days. The 9 patients who experienced clinical VTE had a higher mean ASA score (mean = 2.89, SD = 0.60) than overall participants (mean = 2.47, SD = 0.60).
Conclusions: No LE VTE was detected pre-operatively or in the 24 hour follow-up period. Although these results do not support our original hypothesis, they provide an important piece of the timeline for development of symptomatic VTE. The majority of the VTE events occurred within 30 days and were in orthopedic patients suggesting that no detectable VTE formed intraoperatively.
Author Disclosures: D. Rosen: None. M.F. O’Connor: None. R. O’Hara: None. C.L. Skelly: None. D. Glick: None.
- © 2016 by American Heart Association, Inc.