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Postoperative Venous Thromboembolism after Extracranial Otologic Surgery
Yohan Song1, Jennifer C Alyono1, Noor-E-Seher Ali1
11 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA.
Summary
Postoperative venous thromboembolism (VTE) is rare in otologic surgery patients, even those at higher risk. Current risk assessment models may overestimate VTE incidence in this population, suggesting caution with chemoprophylaxis.
Area of Science:
- Otolaryngology
- Vascular Surgery
- Medical Risk Assessment
Background:
- Venous thromboembolism (VTE) is a significant concern in surgical patients.
- Risk stratification models like the Caprini score are used to guide thromboprophylaxis.
- The VTE risk in otologic surgery patients is not well-established.
Purpose of the Study:
- To determine the incidence of postoperative venous thromboembolism (VTE) in adults undergoing otologic surgery.
- To evaluate the applicability of the Caprini risk assessment model in this patient population.
Main Methods:
- Retrospective cross-sectional study at a single tertiary academic center.
- Analysis of 1213 nononcologic, extracranial otologic surgeries performed between August 2009 and December 2016.
- Identification of VTE events within 30 days post-surgery, documentation of thromboprophylaxis, and calculation of Caprini risk scores.
Main Results:
- No postoperative VTE events were identified in 1268 surgeries (0%).
- The average Caprini score was 4.0, with 85% of patients scoring ≥3, traditionally indicating moderate to high risk.
- The observed VTE rate was significantly lower than predicted by literature for similar risk scores without prophylaxis.
Conclusions:
- Postoperative VTE is rare following otologic surgery, even in patients with elevated Caprini scores.
- The Caprini risk assessment model may overestimate VTE risk in this surgical group.
- Chemoprophylaxis decisions should consider the low VTE incidence against risks of bleeding and impaired surgical visualization.
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