PURPOSE: To assess the incidence and time course of symptomatic venous thromboembolism (VTE) events in patients during and following hospitalization for major orthopedic or abdominal surgery. METHODS: Data were extracted from the Thomson Reuters MarketScan(®) Inpatient Drug Link File for surgical patients admitted between January 2005 and December 2008. The analysis included 8989 abdominal surgery patients and 4220 orthopedic surgery patients. The cumulative risks of VTE and VTE hazard were assessed over a 180-day evaluation period after the hospital admission date, using Kaplan-Meier analysis and LOESS regression, respectively. RESULTS: In total, 305 (2.3%) patients experienced a symptomatic VTE event. These were most frequent during days 1-9 (78 events) and 10-19 (72 events). In all, 64% of events occurred after discharge. Venous thromboembolism hazard peaked at approximately 1.3 per 1000 person-days (day 8) following orthopedic surgery and at approximately 0.52 per 1000 person-days (day 11) following abdominal surgery. In-hospital pharmacologic prophylaxis was received by 88.3% and 30.2% of orthopedic and abdominal surgery patients, respectively, whereas pharmacologic prophylaxis following hospitalization was received by 41.3% and 3.0% of patients, respectively. CONCLUSIONS: The time course of VTE in major surgery patients suggests that VTE risk is highest during the first 19 days after admission and that considerable VTE risk extends into the period after discharge.
PURPOSE: To assess the incidence and time course of symptomatic venous thromboembolism (VTE) events in patients during and following hospitalization for major orthopedic or abdominal surgery. METHODS: Data were extracted from the Thomson Reuters MarketScan(®) Inpatient Drug Link File for surgical patients admitted between January 2005 and December 2008. The analysis included 8989 abdominal surgery patients and 4220 orthopedic surgery patients. The cumulative risks of VTE and VTE hazard were assessed over a 180-day evaluation period after the hospital admission date, using Kaplan-Meier analysis and LOESS regression, respectively. RESULTS: In total, 305 (2.3%) patients experienced a symptomatic VTE event. These were most frequent during days 1-9 (78 events) and 10-19 (72 events). In all, 64% of events occurred after discharge. Venous thromboembolism hazard peaked at approximately 1.3 per 1000 person-days (day 8) following orthopedic surgery and at approximately 0.52 per 1000 person-days (day 11) following abdominal surgery. In-hospital pharmacologic prophylaxis was received by 88.3% and 30.2% of orthopedic and abdominal surgery patients, respectively, whereas pharmacologic prophylaxis following hospitalization was received by 41.3% and 3.0% of patients, respectively. CONCLUSIONS: The time course of VTE in major surgery patients suggests that VTE risk is highest during the first 19 days after admission and that considerable VTE risk extends into the period after discharge.
Authors: Richard E Nelson; Scott D Grosse; Norman J Waitzman; Junji Lin; Scott L DuVall; Olga Patterson; James Tsai; Nimia Reyes Journal: Thromb Res Date: 2015-01-26 Impact factor: 3.944
Authors: Julio J Jauregui; Bhaveen H Kapadia; Anant Dixit; Qais Naziri; David J Hip-Flores; Steven F Harwin; Michael A Mont Journal: Clin Rheumatol Date: 2015-08-04 Impact factor: 2.980
Authors: Kari A O Tikkinen; Arnav Agarwal; Samantha Craigie; Rufus Cartwright; Michael K Gould; Jari Haukka; Richard Naspro; Giacomo Novara; Per Morten Sandset; Reed A Siemieniuk; Philippe D Violette; Gordon H Guyatt Journal: Syst Rev Date: 2014-12-23