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Updated: Sep 20, 2025
Author Spotlight: Advancing Cancer Associated Thrombosis Research in Rodent Models
Published on: January 5, 2024
Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database
Chelsea S Pan1, Yas Sanaiha1, Joseph Hadaya1
1Cardiovascular Outcomes Research Laboratories, Division of Cardiac Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Background:
The present study characterized the incidence of venous thromboembolism in a contemporary cohort of surgical oncology patients and its association with index hospitalization and postdischarge outcomes.
Methods:
Adults undergoing 7 major thoracic and abdominal cancer resections were identified in the 2016-2019 Nationwide Readmissions Database. Multivariable models stratified by operative subtype were developed to evaluate the association of venous thromboembolism with outcomes of interest.
Results:
Of an estimated 436,368 patients, venous thromboembolism was identified in 9,811 (2.2%) patients during index hospitalization. Esophageal (4.1%) and gastric (4.1%) resections exhibited the highest rates of venous thromboembolism, whereas pulmonary resection (1.0%) the lowest. Following adjustment, cancer resection type demonstrated the strongest association with venous thromboembolism development among all factors analyzed (adjusted odds ratio: 3.13, 95% confidence interval: 2.60-3.78). Diagnosis of venous thromboembolism was associated with increased mortality (10.2%, 95% confidence interval: 9.4-11.1 vs 1.7, 95% confidence interval: 1.6-1.7) and prolonged index hospital stay (19.5 days, 95% confidence interval: 19.1-20.0 vs 7.5, 95% confidence interval: 7.4-7.5). Of patients who survived index hospitalization, venous thromboembolism occurrence was associated with increased risk of nonhome discharge (56.4%, 95% confidence interval: 54.7-58.0 vs 14.4, 95% confidence interval: 14.2-14.7) and readmission (30.0%, 95% confidence interval: 28.5-31.1 vs 16.9, 95% confidence interval: 16.7-17.1). Additionally, venous thromboembolism substantially increased index hospitalization ($40,000, 95% confidence interval: $38,000-$42,000) and readmission costs ($3,200, 95% confidence interval: $1,700-$4,700).
Conclusion:
Rates of venous thromboembolism remain high in surgical oncology patients, with cancer resection type as a major predictor of venous thromboembolism incidence. Venous thromboembolism was associated with inferior clinical and financial outcomes that extended beyond discharge. These findings underscore the importance of continued vigilance and procedure-specific prophylaxis measures.
