Sami P Moubayed1, Antoine Eskander2, Moustafa W Mourad3, Sam P Most1. 1. Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California. 2. Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada. 3. Department of Otolaryngology - Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York.
Abstract
BACKGROUND: The purpose of this study was to present our systematic review and meta-analysis of the data on venous thromboembolism (VTE; deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in otolaryngology-head and neck surgery (OHNS). METHODS: PubMed and Scopus databases were searched for studies reporting VTE in OHNS. Incidence of VTE and bleeding is reported and meta-analyzed overall and for chemoprophylaxis and squamous cell carcinoma (SCC)/free flap subgroups. RESULTS: A total of 23 studies were included with a total of 618,264 patients. Incidence of VTE was 0.4%. The incidence of bleeding complications was 0.9%. The addition of chemoprophylaxis did not result in a decreased VTE incidence (odds ratio [OR], 0.86), but produced an increased risk of bleeding (OR, 3.78). The overall OR for VTE in SCC/free flap cases was 6.28. CONCLUSION: Chemoprophylaxis may not be necessary in the OHNS non-SCC or free flap patient population and must be balanced against an increased risk of bleeding.
BACKGROUND: The purpose of this study was to present our systematic review and meta-analysis of the data on venous thromboembolism (VTE; deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in otolaryngology-head and neck surgery (OHNS). METHODS: PubMed and Scopus databases were searched for studies reporting VTE in OHNS. Incidence of VTE and bleeding is reported and meta-analyzed overall and for chemoprophylaxis and squamous cell carcinoma (SCC)/free flap subgroups. RESULTS: A total of 23 studies were included with a total of 618,264 patients. Incidence of VTE was 0.4%. The incidence of bleeding complications was 0.9%. The addition of chemoprophylaxis did not result in a decreased VTE incidence (odds ratio [OR], 0.86), but produced an increased risk of bleeding (OR, 3.78). The overall OR for VTE in SCC/free flap cases was 6.28. CONCLUSION: Chemoprophylaxis may not be necessary in the OHNS non-SCC or free flap patient population and must be balanced against an increased risk of bleeding.
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