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Venous thromboembolism in reconstructive pelvic surgery.
Margaret G Mueller1, Matthew A Pilecki2, Tatiana Catanzarite3
1Division of Female Pelvic Medicine and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
American Journal of Obstetrics and Gynecology
|July 29, 2014
Summary
The incidence of venous thromboembolism (VTE) after reconstructive pelvic surgery (RPS) is low, but higher when combined with other surgeries. Inpatient status, higher ASA classification, and emergency intervention increase VTE risk.
Area of Science:
- Urology
- Gynecologic Surgery
- Surgical Outcomes
Background:
- Venous thromboembolism (VTE) is a significant complication following major surgery.
- Reconstructive pelvic surgery (RPS) involves complex procedures with potential VTE risks.
Purpose of the Study:
- To determine the incidence of VTE in women undergoing RPS.
- To identify risk factors associated with postoperative VTE in this patient population.
Main Methods:
- Analysis of the American College of Surgeons National Surgical Quality Improvement Program registry (2006-2010).
- Inclusion of patients who underwent RPS, categorized into two cohorts: RPS with other surgeries and isolated RPS.
- Statistical analysis using chi-squared tests, Student t tests, and multiple logistic regression.
Main Results:
- Overall VTE incidence was low (0.3% in RPS + other, 0.1% in isolated RPS).
- Predictors for VTE in the combined surgery cohort included inpatient status (OR, 7.69), higher ASA classification (OR, 2.70), and emergency intervention (OR, 3.65).
- For isolated RPS, longer length of stay was the only specific predictor of VTE.
Conclusions:
- VTE incidence following reconstructive pelvic surgery is low.
- Concomitant surgeries increase VTE risk.
- Inpatient status, higher ASA classification, and emergency intervention are key risk factors for VTE after RPS.
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